CACHE Level 2 Certificate in

Preparing to Work in Adult

Social Care RQF

Lorem ipsum...

Lorem ipsum...
Introduction and Guidance

The Level 2 certificate is made up of a number of different units of assessment which

sit within the RQF (Regulated Qualifications Framework) / Level 3 MQF (Malta
Qualification Framework). When you complete a unit successfully, you will gain a
certain number of credits. A credit is based on how long an average learner would
take to complete a unit, and one credit is roughly equal to 10 hours of learning.

Unit Structure and Content

Each unit contains a number of sections relating to different aspects of the overall topic
with which it is concerned. Each section contains both descriptive text and a range of
questions that are designed to test and help you demonstrate your understanding of
the material covered.

Activities

The activities that you must complete in the activities section will support your role.

You should start by familiarising yourself with the course, its content, and its
requirements and consider how you will meet these. You should also think how you
will structure your time to enable you to complete it.

When working through a unit you should first read through it fully, ignoring references
to questions that you may find in the text at this stage. When you have done this, you
should go back to the beginning of the unit once more, read through the text, and this
time answer the questions in the activities section of the course.

To successfully complete your course, you will have to fulfil the assessment criteria for
each unit.
Welcome to the programme

Who does this programme benefit?

This qualification provides an ideal taster for learners who may be new to the sector
or new to the world of work. It is accessible to learners of all ages who may want to
understand more about working in health and social care. It aims to introduce some
basic concepts of caring and preparation for employment in the sector.

It aims to introduce knowledge around the following areas relating to working in adult
social care:

• communication
• equality, diversity and inclusion
• personal development
• role of the social care worker
• handling information
• health and safety
• safeguarding
• duty of care
• person-centred approaches.

Study support in the workplace

This learning programme has been designed to be as self-contained as possible to

help guide you through your studies. However, if this study relates to your current work,
help and advice in your workplace is very important as it can help you to apply your
studies to the way you care for your own service users.

There may be times when you need to clarify issues related to the questions in the
assessment section or discuss your progress with others. Make time to talk with
colleagues who are also completing the programme.

It is often good to find that their needs are the same as yours, and the process of
talking things through will assist with your learning. It is important to discuss issues
with your line manager, or supervisor, on a regular basis.

Completion of the programme

When you have completed the programme, your tutor/assessor needs to verify that
you have worked through all parts of the assessment section and completed all of the
questions successfully.

Recognition and Certification

Upon successful completion of the assessment section, a nationally recognised

certificate will be awarded to confirm your achievement.
Contents

Unit 1 Principles of Communication in Adult Social Care Settings

Unit 2 Principles of Personal Development in Adult Social Care Settings

Unit 3 Principles of Diversity, Equality and Inclusion in Adult Social Care

Settings

Unit 4 Principles of Safeguarding and Protection in Health and Social Care

Unit 5 Introduction to Duty of Care in Health, Social Care or Children’s and

Young People’s Settings

Unit 6 Understand the Role of the Social Worker

Unit 7 Understand Person-Centred Approaches in Adult Social Care

Settings

Unit 8 Understanding Health and Safety in Social Care Settings

Unit 9 Understand How to Handle Information in Social Care Settings

Unit 1 Principles of Communication in Adult Social Care
Settings L/602/2905

Unit purpose and aims

The unit introduces the importance of communication in adult social care settings, and
ways to overcome barriers to meet individual needs and preferences in
communication.
This unit is aimed at those who are interested in, or new to, working in social care
settings with adults.

Learning Outcome 1
The learner will:
Understand why communication is important in adult social care settings,
The learner can:
1.1 Identify different reasons why people communicate.
1.2 Explain how effective communication affects all aspects of working in adult
social care settings
1.3 Explain why it is important to observe an individual’s reactions when
communicating with them

1.1 Reasons why people communicate

To communicate effectively with people, it is helpful to understand what is involved in
the communication process and what it means.

Message

Sender
Receiver

Feedback to show
understanding

For genuine communication to occur, this has to be a two-way process involving a

number of aspects. If any part of this process fails, communication will break down.
There are many reasons why people communicate, and these will vary according to
the person, the circumstance and situation. These reasons may include:
• Forming and maintaining relationships
• Giving and receiving information
• Making an individual’s, needs, wishes and preferences known
• Understanding the needs, wishes and preferences of others
• Conveying feelings, thoughts and opinions
• Understanding the feelings, thoughts and opinions of others
• Enabling and enhancing learning and understanding
• Instructing and teaching
• Building and maintaining self-esteem, a sense of security and promoting
feelings of belonging
• Enabling choice by giving individuals options

This list is not exhaustive, and you may be able to think of many other reasons.

1.2 Communication in adult social care settings

Effective communication impacts on all aspects of working within an adult care setting.
Every aspect of care involves effectively communicating with the individual themselves
and those involved in assessing, planning, implementing and evaluating care
holistically. If you want to be a good care worker, you will need to have good
communication skills. This is key in order to help build relationships and provide the
best quality care.
People you may communicate with:
• The immediate care team
• Other care professionals within and outside the care organisation
• Family, friends and carers
• Work teams who support the work you do (e.g., Domestic, catering,
maintenance)
• Other agencies who provide services resources and support to care staff,
individuals and their families

Effective communication will impact positively on all aspects of the care setting.
Therefore, those within it will benefit as work teams co-operate and collaborate in order
that individuals receive the best quality of care.

Understanding communication
Why is communication important?
Effective communication:
• Increases the chances of an effective working relationship between
professionals and individuals.
• Affects the way policies, procedures and legislation are understood and
followed. Directly impacting on health, safety, security and the quality of care
delivered.
 • Decreases the chances of individuals feeling patronised. Many individuals will
have lost their independent lifestyles and it is extremely important to help them
retain as much independence as possible
• Will help to reassure individuals who have recently been admitted to your care
environment, their family and friends as they may be feeling anxious
• Will reduce the likelihood of omissions and errors
• Will allow realistic goals to be set
• Reduce fears and anxiety and keeps individuals informed
• Increases understanding

1.3 The Importance of observing an individual’s reactions when

communicating
Immediately before and during communication with an individual you will make your
own personal observations about that person and their reactions to the
communication. Your observations will directly influence the way in which you
communicate with them. You will quickly assess the way in which you need to
communicate in order to meet the needs, wishes and preferences of the individual.
Every person is different in the way they will react and, to a large extent the individual’s
reaction will depend upon the nature of the information that is being communicated.
Having an understanding of the types of reactions that individuals may display will help
you to understand and support the feelings that a person may experience. The
person’s feelings may not be initially apparent, but it is important to observe the
individual’s body language in order to assess their feelings and provide the support
that they may need.

How individuals react and respond both verbally and non-verbally during interaction
will show whether they have understood what has been communicated to them. An
individual may not tell you that they are confused or worried, but you may be able to
pick up signs from their body language or facial expressions.
Learning Outcome 2
The learner will:
Understand how to meet the communication and language needs, wishes and
preferences of an individual.
The learner can:
2.1 Explain why it is important to find out about an individual’s communication and
language needs, wishes and preferences
2.2 Describe a range of communication methods

2.1 The importance of finding out about an individual’s communication and

language needs, wishes and preferences
Assessment of needs
All communication should focus on the individual, their needs, preferences and
method and style of communication. Full assessment of needs should be carried out
and a care plan developed with the involvement of the individual. All those involved
in the care of the individual, should be fully aware of the contents of the plan of care
and work together to promote effective communication. Taking a comprehensive
history during the admission process will assist this, as any communication difficulties
may be highlighted.
Obtaining information about individuals’ communication and language needs
and preferences
It is essential that you are aware of the person’s communication needs, so they can
be supported. In order to obtain information about a person’s communication
preferences and needs it is essential that you know something about that person. You
can:
• Speak to the individual and find out more about them. Certain individuals
may be unable to communicate, and it is vital you seek advice.
• Read the individual’s care plan where the individual’s needs, likes and
dislikes should be outlined. Some individuals may have a communication
passport which will describe their preferred method of communication.
• Liaise with other care workers it is essential that communication differences
are communicated to all staff
• Liaise with key people such as family and friends of the individual. If an
individual is not able to express their needs to you, family and friends may be
able to give valuable information. Remember to view this source of information
objectively, as information may be subjective and therefore not entirely accurate
• Liaise with other health care professionals such as speech and language
therapists, nurses etc

It is essential that any assessment of communication needs and preferences consider

the person as a whole.
2.2 Styles and methods of communicating
When communicating within your workplace, it is not only the way that you
communicate with others that is important. You can speak as clearly as you like, but if
the person who is receiving your message cannot hear you then the process will break
down. You also need to consider the person who is receiving the message and whether
the way that you are communicating is appropriate to their ability to receive and
understand the message.

Preferred ways of communicating

It is essential that individuals can communicate in the way that they know how and the
way that they prefer. Preferences may be based on:
• Beliefs
• Values
• Culture

All of which may affect how, when and with whom the person prefers to communicate.

Respecting the needs of differing cultures

When communicating with individuals it is important to take into account the barriers
that cultural differences may bring. Languages differences can create a barrier to
communication, and it is important to be aware of how you can help overcome this
obstacle. Between the health care worker and the individual there may be:
• Differences in the use and understanding of individual words
• A lack of understanding of languages, accents and dialects
• Misunderstanding of body language and gestures

By being aware that differences in languages may lead to problems with

communication, steps can be taken in order to reduce miscommunication from
happening. You can help to support clients by ensuring that you take steps to minimise
the reasons why they should have difficulty in communicating.
Their chosen way, however, should be appropriate and socially acceptable, taking into
consideration the rights of and respect for others.
Whilst encouraging individuals to communicate you must remember that individuals
should never be forced into communicating. Those with speech difficulties may find
the process of trying to speak very tiring and frustrating. They should be free to choose
the use of gestures, symbols, drawing and the written word if they wish, providing this
does not interfere with therapy or progress.
Some individuals may not wish to communicate at all. This may be due to a specific
communication difficulty or a psychological or emotional reason. This should be
reported so that the client can be referred for assessment by specialists.
It is especially important to remember that the person receiving care is an individual
with their own communication skills and style. Ensuring that you speak at a level and
pace to suit each individual is a skill that will take time and practice to perfect.
The individuals that you care for have a right to communicate in the way that they
prefer, and it is an important part of your work that you offer these people choice in
how they communicate. This demonstrates that you respect their right to be different
and to make their own choices. It is essential to know how individuals prefer to
communicate to avoid any unnecessary upset and distress.

Understanding communication
No communication can be successful if one of the parties involved does not understand
what the other is trying to communicate. There may be a variety of reasons for this,
ranging from a physical or psychological barrier, to lack of understanding of language,
dialect, accents, the use of complicated language, unfamiliar words or medical jargon.
Communication can break down due to either party misunderstanding or
misinterpreting what is being conveyed. This can happen even in the absence of a
communication barrier and can be due to something as simple as misunderstanding
or misinterpreting a gesture, facial expression or the tone of voice.
It is vital that you ensure that you understand and make yourself understood. If there
are problems, adapt your communication and seek extra support if necessary.
The forms of communication
Verbal communication
Verbal communication is words, or substitutes for words,
using the individual’s first language. This language may be:
• Spoken
• Signed (e.g., British Sign Language for the Deaf)
• Or employ another method using Technology

Methods of technology may vary. For example, a hearing aid is a ‘low-tech’ use of
technology to help communication. A more ‘high-tech’ method to assist a disabled
client to communicate more effectively, may involve the use of a computerised system.
The method used will depend on the individual needs of the individual.
Verbal communication can also involve:
• Vocabulary (the words spoken)
• Linguistic tone (tone of the voice)
• Pitch

When verbally communicating it is important to think about you are saying. The verbal
information you are sharing should be accurate. If you give a poor explanation this
could cause confusion and lead to a misunderstanding.
Try to use open questions, which will encourage individuals to talk rather than give a
one-word answer. You may have to repeat information and avoid using jargon or slang
words, which individuals may not understand.
You need to consider you tone and pace when communicating verbally. You should
speak clearly and slowly, which will help an individual understand what you are trying
to say.

Written communication
Verbal communication cannot be relied upon, as information can be misunderstood or
forgotten. Information about individuals must be written down.

A whiteboard or pen and paper could be used to enable and encourage interaction
with an individual who may experience difficulties in communicating verbally.

Active listening
Communication is not all about talking. Listening has a major role in ensuring that
communication is effective. Listening is not just about hearing what is said. It is about
understanding and showing this understanding to those you are listening to.
Effective listening can be achieved using facial expressions, maintaining eye contact
and appropriate use of body language. Adopting a relaxed posture and looking
interested will encourage your individual to speak. This is called “active listening”.
Showing a person, you are listening will make them feel you are interested and that
they are valued.
Effective Listening = Active Listening

Non-verbal communication
A great deal of communication occurs non-verbally through body language. This
includes:
• Touch
• Dress
• Facial Expression
• Eye Contact
• Posture
• Proxemics (how close we come to the
other person)
• Gesture

A more reliable way of discovering an individual’s true feelings is the way in which they
communicate non-verbally, especially by the use of facial expressions.
Space and position
It is important, when communicating with others, to realise the importance of space
and position. Different situations and circumstances, with different people, will require
us to decide what is appropriate, as far as the distance from the individual and the
position you adopt. What is appropriate for one person may not be appropriate for
another. We all like our personal space and do not wish people to invade that space,
unless we invite them to do so, or that you have a relationship that will allow you to do
this, e.g., close family / close relationships. Certain circumstances within the care
setting will allow you to invade that space, e.g., care giving activities. However, getting
too close to an agitated or aggressive individual for example, can be inappropriate and
may exacerbate the situation further. Actions such as sitting, standing or bending
down, may convey different things in different circumstances.

Eye contact
Maintaining eye contact will convey interest and show you are listening. Frequently
looking away or avoiding eye contact may suggest the person is uncomfortable or
does not wish to communicate. Likewise, continuous uninterrupted eye contact will
feel uncomfortable and may be seen as threatening or confrontational. Some
individuals may find the act of making eye contact stressful, you must respect this and
adapt your communication accordingly.

Acceptable use of physical contact and touch

When communicating it is vital to understand what type of physical contact is
acceptable and what is not. You must also understand the circumstances in which
certain types of physical contact, such as touch, can be used. Physical contact should
never be used to relieve your own distress.

Acceptable forms of physical contact

• Holding an individual’s hand
• An arm around the shoulders
• During physical care activities (e.g., bathing etc).

This must be agreed with the individual and care team and consistent with the care
plan and the needs of the individual.

Unacceptable forms of physical contact

• Invasion of personal space
• When the individual is made to feel uncomfortable
• Inappropriate restraint
• Where the contact is abusive (e.g., physical assault or any form of sexual
contact)
Situations where physical contact can be useful
• To communicate care and concern
• To aid recognition by a visually impaired individual

Situations in which physical contact must not be used

• When cultural issues make contact unacceptable
• When the client’s body language suggests this is not acceptable
• Where the actions may be misinterpreted

The appropriate use of physical contact can help to form relationships between
individual and care worker. Individuals can be reassured and made to feel valued
and cared about. However, all individuals must be assessed individually as what is
considered acceptable and appropriate by one person may not be by another.

Facial Expressions

Facial expressions can indicate how a person is feeling. It is important to consider your
own facial expressions when communicating. Smiling will encourage an individual to
feel comfortable and reassured. Observing facial expressions will enable you to offer
the correct support and adapt your communication. An individual may show signs of
confusion by scrunching their forehead and nose and having pursed lips. An individual
who is angry may display a tensed and strained facial expression and their head may
be slightly lowered, looking through their brow.

Allowing individuals time to communicate

To give the individual time to communicate and to allow the individual to communicate
effectively you need to let them know that you are listening and that you are interested
in what they are saying. You can do this by showing that you are relaxed, and that the
individual has your full attention. This will give them the confidence to communicate in
a supportive environment.

Silences
Silences give the speaker a chance to think and plan their reply. They are especially
useful for those who have problems understanding, hearing, or expressing speech. A
vital part of your role as the listener is to ensure that silences do not make the individual
feel uncomfortable or awkward.

Other forms of communication

There are other ways in which we can communicate.

Objects of reference

These could be items which reinforce what you are trying to say. It could be items of
clothing, cutlery, toys or something that has a special meaning to the individual. If you
trying to communicate to an individual that it is lunchtime, you may show them a plate
or knife and fork. It is important that all health professionals work consistently and use
the same objects of reference to avoid causing confusion.

Makaton

This language uses signs and symbols to help people to communicate. Signs will be
made via the hands, making different movements and shapes. Using signs can help
individuals who have no speech or whose speech is unclear. Using a combination of
signs, symbols, and speech it promotes interaction and encourages an individual to
communicate their needs, wishes and feelings.

Picture Exchange Communication System (PECS)

This system uses symbols and pictures to support communication. An individual will
have their own pictures which they can use to communicate, such as showing a picture
of a drink. You can use the pictures and symbols to initiate a conversation, share
information and give instructions. It could be in the form of a communication book
which is personal to the individual.

Braille

This is used by individuals who are blind or visually impaired. It is system of raised
dots that people can read with their fingers.

Voice Output Communication Aids (VOCAs)

There are several devices that are designed to support individuals who are unable to
communicate verbally. They produce spoken words to help the individual to
communicate. Some devices store the words and phrases enabling the individual to
put together messages which are then spoken out by the device.

Learning Outcome 3
The learner will:
Understand how to reduce barriers to communications.
The learner can:
3.1 Identify barriers to communication
3.2 Describe ways to reduce barriers to communication
3.3 Describe ways to check communication has been understood
3.4 Identify sources of information and support or services to enable more effective
communication.

3.1 Barriers to communication

Communication is about a speaker talking to a listener (sender to receiver). Although
we may think this is a simple process, this is not always so. There are a number of
barriers or obstacles that can affect the way the message is sent or received. These
may be present initially or may develop as individuals’ needs and preferences change.
Any changes must be reported and recorded immediately, in order for the individual’s
needs to be met.

Physical barriers
The individual may experience:
• Hearing or visual impairment
• Speech impairment
• Mobility problems
• Physical disability
• Pain

Mental health barriers

The individual may become:
• Isolated from others, due to the impact of the illness on the ability to
communicate
• Detached from reality
• Attitudes, beliefs and ideas can significantly affect the way that people
communicate
• Believing that personal issues must not be discussed with those outside the
family group when dealing with individuals with mental health problems

Cultural barriers
Between the two parties there may be:
• Differences in the use / understanding of individual words
• A lack of understanding of language, accents and dialects
• Misunderstanding of body language and gestures
• Differences in the interpretation of body language and gestures

Personal barriers
The individual may have:
• A quiet, shy personality that prevents them from communicating
• An impatient, abrupt or loud manner that makes others feel uncomfortable

Care worker and others

Care workers and others, such as relatives, can create barriers to communication.
These are rarely deliberate and are generally due to misunderstandings. A lack of time
could cause a barrier to communication. Care workers who have little time to spend
communicating will mean they are unable to find out about the individual and what they
like. A lack of training on how to communicate effectively and not knowing the preferred
method of communication will create a barrier when trying to interaction.
Stereotyping and labelling
Making judgements about an individual because they belong to a particular ‘group’ or
based on other people’s unreasoned comments is called stereotyping. This can have
a negative effect on the way an individual is treated and can lead to unfair
discrimination.
Labelling can lead to the individual being considered as ‘demanding’, ‘awkward’, or
‘difficult’, or elderly people being treated as if they are all ‘forgetful’, ‘confused’ or ‘hard
of hearing’.

Environmental barriers
Factors such as:
• Background noise / interruptions
• Poor or very bright lighting
• Extremes of temperature
• Uncomfortable seating
• Unattractive or unwelcoming décor and furnishings
• Lack of privacy

Understanding difficulties
Those with hearing problems may have difficulty understanding conversation because
they cannot hear the words.
Other individuals such as those with dementia, a brain injury, following a stroke or
those with conditions like autism or learning disabilities, may be able to hear the words
but either do not understand the meaning of the words or do not remember what has
been said.

Empathy
Empathy is the ability to understand the world as it appears to another person, by
putting yourself in their position. This is a skill that will help you to understand why
people behave in certain ways. It will also enable your individuals to feel that you can
see things from their point of view. This will develop a relationship based on trust and
understanding and enhance the quality of care you deliver.

Changes
It is extremely important to recognise any key changes in the individual’s ability to
communicate effectively. Communication skills and abilities should be assessed,
reviewed and evaluated. All those involved in communication with the individuals,
should be aware of the initial assessment, to enable them to recognise any key
changes. Any changes should be recorded and reported, and your approach adapted
to respond to the change identified. An urgent review may be needed, referrals made
to the appropriate care professionals and changes made to the plan of care.
There are a number of ways in which you can recognise key changes in
communication:
• Listen carefully • Collect information from a variety
• Observe body language of sources, including colleagues,
• Observe actions and behaviour the individual, family and friends

It is important to monitor communication and recognise and respond to change, in

order for individuals’ needs to be met fully.

3.2 Reducing barriers to communication

In order for barriers to effective communication to be reduced, various ways need to
be developed within the work team. These are only likely to be effective after a full
assessment of these barriers has been completed. Information should be
communicated effectively, verbally, and written accurately, completely and legibly.

Physical
Assessment of sight, hearing and mobility needs
• Providing aids and equipment
• Hearing aids have a functioning battery. Understand their use and maintenance
• Spectacles are clean and worn when required
• Adjusting the level and pace of communication to suit the individuals’ needs
• Being patient with those who have problems expressing speech
• Providing a clear description for a visually impaired individual
• Facing a person who is hard of hearing
• Assisting individuals with mobility problems to access areas where
communication can take place
• Treatment to alleviate problems e.g., new spectacles, eye surgery, removal of
excess ear wax

Report any problems you are unable to deal with to your manager who can arrange
for specialist support for individuals’ e.g., speech therapists. Education and training
can also be arranged for you.

Cultural
• Being aware of language differences - an interpreter may be required
• Using body language and alternative ways of saying things when an individual
misunderstands
• Speaking in short, clear sentences
• Using your listening skills to check understanding
• Making greater use of pictures and non-verbal communication
• Being aware of the way different cultures understand, and express themselves
Personal
• Accepting personality differences
• Supporting, respecting and understanding the client
• Providing feedback and encouragement
• Showing acceptance of the person
• Providing encouragement to communicate
• Adapting communication to accommodate changing needs and preferences

Care worker
• Practicing self-appraisal to identify knowledge and understanding
• Asking for help to address areas of which you are unsure. This may be
especially relevant when you first become a care worker, as you may have had
little experience of ill or disabled people and limited contact with care
professionals. The importance of gaining support, advice and guidance from
your colleagues and manager cannot be overstated. This will prepare you to
communicate effectively and will eventually enable you to support others
• Obtaining education to develop knowledge
• Taking the time to get to know the individual

Environmental changes
An environment which has been thoughtfully designed can assist individuals to
communicate effectively and make their needs and wishes known.
• Check and adjust lighting and reduce background noise
• Ensure the level of heat is appropriate and comfortable
• Provide privacy and areas for socialising
• Ensure the seating is comfortable and positioning enhances communication
• Assistance to access
• Provide pleasant and welcoming décor and furnishings
• Keep interruptions to a minimum

Care worker interventions

• Be sure of the nature and scope of the communication barrier and the
individuals’ plan of care
• Don’t wait for the individual to approach you. Don’t make the individual feel
communication only takes place when absolutely necessary – initiate
conversation
• Adopt a relaxed posture, showing you have time to listen and converse
• Face the individual, avoid covering your mouth or turning away – this is
particularly important if the individual lip reads
• If a mask must be worn due to infection control measures ensure you make eye
contact with the individual, speak slowly and clearly, and raise your voice
without shouting.
• Ensure speech is clear and at a manner, level and pace to suit the individuals’
needs
• Do not dominate the conversation or suddenly change the subject
 • Use non-verbal communication to enhance verbal communication
• Observe the individuals’ body language to assess understanding
• If the individual mis-hears and responds inappropriately, do not be afraid to
repeat yourself or ask the client to clarify or confirm that they understand
• Allow the person time and space to respond
• Write things down and use symbols
• Report any changes immediately

If others are present:

• Make sure they are aware that the individual has a communication barrier – be
tactful and maintain confidentiality
• Do not answer for the individual
• Be patient – imagine how you would feel in the person’s position

Lack of understanding
This can be extremely distressing for the person, especially if they have the insight to
realise something is wrong. This is called ‘receptive dysphasia / aphasia’. The brain
cannot ‘unscramble’ the spoken words and the individual can understand little or
nothing of what is being said. When the brain has been damaged due to injury caused
by stroke or trauma, rehabilitation will play a major part in the individuals’ treatment.
You should be guided by therapists who will advise on speech therapy and the use of
gestures, signs, symbols and the written word. Remember, be patient with the
individual as they may become very frustrated as they may feel everyone is speaking
a language they do not understand.
In dementia, this type of problem usually occurs later in the process, making it virtually
impossible to communicate with individuals. This is where the use of non-verbal
communication such as the tone of voice, facial expressions, the use of touch and
visual aids such as pictures and symbols become particularly important.

Ways to adapt communication

Communicating becomes more challenging when there is a barrier to communication.
Using touch to enhance verbal communication, to get a person’s attention or to convey
a message can be highly effective. Allowing the individual to use touch may also be
an acceptable way for the individual to communicate with others and be a useful
vehicle for communication when an individual is unable to communicate in other ways.
To fully support individuals to communicate with others you may need to ensure that
specific aids are provided. This will involve working with other members of the
multidisciplinary team and calling upon them for their expertise and help. It is essential
that everyone involved in the care of individuals has access to the same information
which will be based upon a thorough assessment of the individual’s communication
needs. It is essential that any concerns that are outside your level of understanding
and competence are reported to your manager who can arrange for specialist support
for individuals’.
You need to take extra care to ensure that any accents or dialects do not create
barriers and that you avoid complicated language and medical jargon. Communication
should be adapted to suit individuals and the circumstances in which communication
takes place. Use should be made of any recommended aids to communication.

Reviewing practice
It is essential that you be given the opportunity to reflect on your own behaviour,
communication skills and your reaction to different people. The purpose of this is to
explore both aspects of your practice you do well, and those that you may be able to
improve upon.

3.3 Ways to check communication has been understood

Checking information
It is essential that all information is checked with the source for accuracy. The
consequences of misunderstanding or misinterpreting information can be serious.
Individuals may, as a result, not be able to communicate their needs, causing their
physical and mental health to suffer. Inaccuracies and omissions can lead to staff
inadvertently mishandling situations, with the result that communication breaks down
or fails to develop at all.
It is essential that following any communication you clarify the individual’s
understanding of what has been said. You simply do this by asking the individual if he
or she understands everything that has been discussed. By using appropriate
methods of communication and checking the individual understands, any
misunderstanding can be cleared up, which could otherwise lead to unnecessary worry
and distress.

Asking an individual to repeat information back to you can be an effective way of

checking they have understood what you are trying to say. You could also ask them a
question about the information you have shared to determine if they have understood
it correctly.

Observation
It is vitally important to observe the person’s verbal and non-verbal responses. Even
if an individual indicates verbally that they understand, their facial expression or other
non-verbal communication and behaviour may suggest they do not. Therefore, it is
vital that all aspects are taken into consideration to ensure communication is
understood, to fully meet the needs, wishes and preferences of individuals.
3.4 Support, resources and services

Support of agreed others

It is vital you seek support to enable you to communicate with and understand
individuals, so the individual can understand and communicate with you. The advice
and guidance of appropriate people should be sought, so additional support, such as
education and training, can be accessed. Your manager will probably be responsible
for this.
Extra support to enhance understanding may include:
• Speech and Language Therapy • Social Workers for the Deaf and /
• Referral to Audiologists, Ear, or Blind
Nose and Throat Specialists, • Occupational Therapists
• Ophthalmologists or Opticians • Social workers
• Mental Health Teams • GP
• Translators • Physiotherapists
• Interpreters • Pharmacist
• Advocacy services • Nurse/Specialist Nurse
• Dementia Care advisor
• Family or carers

Translation and interpreters

Some organisations have provision for translation of written material. This may include
information booklets and charters. Written material may also be translated to the
spoken word.
Individuals, whose first language is not English, may require the service of an
interpreter. For the purposes of accuracy, objectivity and confidentiality, the use of
family (especially young children) and friends, should be viewed with caution.

Advocate
A relative who is acting on behalf of the individual must have their consent before
records are shared, unless that person is the individuals’ legal guardian or is a
representative appointed by the courts. Independent advocates can be appointed to
act on behalf of an individual who is unable to represent their interests themselves.
Records may be shared with an advocate to ensure that individuals’ needs are being
met and their rights upheld.
Learning outcome 4
The learner will:
Understand confidentially in adult social care settings
The learner can:
4.1 Define the term “confidentiality”
4.2 Describe ways to maintain confidentiality in day-to-day communication
4.3 Describe situations where information normally considered to be confidential
might need to be shared with agreed others
4.4 Explain how and when to seek advice about confidentiality

4.1 Defining confidentiality

Confidential: to be kept secret; not to be disclosed.
It is extremely important for you to understand the meaning of confidentiality and what
constitutes confidential information in order that, you, as a care worker, can maintain
confidentiality in the care setting. Confidentiality will apply to verbal, written and stored
information and will also include the access, retrieval and transmission of information.
The importance of maintaining confidentiality throughout any form of communication
cannot be overstated. Breaches of confidentiality can have serious consequence for
the individual, who may lose trust in the care worker. The care worker may face
disciplinary action by the employer if guidelines are breached.

4.2 Maintaining confidentiality

Precautions to maintain confidentiality

Individual’s details should only be discussed or written in private; in areas where

information cannot be overheard or overseen. Discuss with your manager what
information you should share and in what
circumstances.
NEVER discuss confidential information in public areas,
with other individuals or visitors, or outside the
workplace. The individual must give permission for
confidential information to be shared, but before you do
this, check with your manager.
You should not reveal confidential information over the telephone. Callers should be
referred to the manager or trained nurse.

Any records relating to an individual must be stored securely and not left out for others
to access. Once you have updated the record, it should be returned immediately.
Computers or devices must be password protected, passwords must not be shared,
and they should be updated on a regular basis. You should always log off a computer
or device once you have finished and return the device to a secure location.
In accordance with the following legislation, it is important that personal information is
held with consent, it should be stored securely, only shared with authorised people and
it must be accessible to the individual.

The Data Protection Act (DPA) 2018

The DPA 2018 sets out the framework for data protection law in the UK. It has replaced
the Data Protection Act 1998 and it sits alongside the GDPR and outlines how the
GDPR applies in the UK. The DPA consists of these elements:

• General data processing

• Law enforcement processing
• Intelligence services processing
• Regulation and enforcement.

The General Data Protection Regulation (GDPR)

These regulations are European-wide and replaced the Data Protection Act 1998.
Even though the UK is no longer a member of the EU, many of principles still apply in
the UK. It explains how organisations must handle personal data. It has 7 key
principles:

1. Lawfulness, fairness and transparency

2. Purpose limitation
3. Data minimisation
4. Accuracy
5. Storage Limitation
6. Integrity and confidentiality
7. Accountability

The Human Rights Act 1998

Under this legislation our human rights are protected, such as the right to security and
freedom of expression.

4.3 Sharing confidential information

Whilst you may fully understand the concept of confidentiality, deciding whether to
share the information that you receive with others, especially when it is of a serious
nature, can be an exceedingly difficult decision to make.
Confidential information can be disclosed to an appropriate health care professional if
it is relevant to the care of that individual. It is justified on the basis that the individual
may suffer if that information is withheld, e.g., not passing on the fact that an individual
has an understanding difficulty may result in that individuals needs not being identified.
Individuals giving information in confidence, have a right to expect that it will only be
used for the purpose for which it was given, and that it will not be shared with others
without their consent. Care staff are not released from this responsibility, even when
a person dies.
Information care workers are expected to share
You have a duty of care to protect vulnerable individuals from abuse. If an individual
reveals that they are being abused, you must reveal this to your manager to protect
them.
If a person indicates that their health and social well-being is at risk, or that they are
suffering symptoms which may be signs of ill-health (mental or physical), which are in
the plan of care and need to be acted upon, you must report and record this.
Information which directly affects the care organisation, and its effectiveness must be
reported.
These requirements may be identified in documents such as legislation, codes of
conduct, plans of care, policies, and procedures. Individuals must be clearly told by
the care worker that the information they have revealed cannot be kept secret, must
be reported to the manager and the reason why.
Information will also be passed within the care team. This will be done both formally,
during meetings and handovers, and informally, during discussions and conversations.
Even though you can legitimately disclose information with the individual’s consent.
You must ensure you are aware of your responsibilities and the possible limitation of
your role. Therefore, you must always ensure you work within agreed boundaries and
seek advice from management before confidential information is shared.
If an individual is unable to give consent advice must be taken from management who
will act on guidance contained in legislation and organisational policies and
procedures.

4.4 How and when to seek advice about confidentiality

It is vitally important that if you have any questions, queries or concerns with regard to
the maintenance, sharing or disclosing of either verbal or written confidential
information that you seek advice from your line manager. Your care organisation will
have policies, procedures, and guidelines to advise and inform you should you need
advice and guidance. These policies will reflect current legislation, codes of practice
and regulations and should always be adhered to.

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now complete the activities, workplace tasks and reflective journal before
proceeding onto the next unit.
Unit 2 Principles of Personal Development in Adult Social Care
Settings L/602/3035

Unit purpose and aims

The unit introduces the concepts of personal development and reflective practise,
which are fundamental to adult social care roles. This unit is aimed at those who are
interested in, or new to, working in social care settings with adults.

Learning Outcome 1
The learner will:
Understand what is required for good practice in adult social care roles.

The learner can:

1.1 Identify standards that influence the way adult social care job roles are carried
out.
1.2 Explain why reflecting on work activities is an important way to develop own
knowledge and skills.
1.3 Describe ways to ensure that personal attitudes or beliefs do not obstruct the
quality of work.

1.1 How legislation and standards influence adult care job roles
These are responsibilities, which must be fulfilled by you, your colleagues, other
agencies, other health care professionals and your employer.

Where these responsibilities are documented (written):

• Legislation (Laws)
• Organisational Policies and Procedures (e.g., Equal Opportunities and
Diversity of People Policy)
• Contract of Employment
• Job Description
• Care Plans
• Educational material (books, videos, audio tapes, contents of this course)

What these responsibilities are:

• Maintain health, safety and security at all times

• Uphold the rights and choices of individuals
• To behave in a way which does not discriminate against any individual
• To maintain confidentiality
• To ensure that you or others do not abuse or neglect
• Reduce the risk of abuse in your care environment
• Report any incident or allegation of abuse or neglect
• Communicate effectively with others
• Maintain high standards of practice at all times
 • Treat all individuals with respect, maintain their privacy, dignity and individuality
• Contribute to good team working
• Report any concerns regarding care or teamwork issues immediately
• Maintain knowledge and understanding through education
• Specific aspects of the job role detailed in Job Description, Contract of
Employment and Organisational Policies

As you can see, responsibilities you and others have are many and varied. Some of
these will be:

General: Maintaining Health and Safety

or
Specific: These will be responsibilities that are specific to your role such as
assisting individuals with personal care.

Legal aspects
You have a responsibility to keep your practice up to date and access education.
However, this does not exclude your manager from their legal responsibilities. The
Health & Social Care Act (2012) requires all managers to ensure that training is
provided to care workers, covering several aspects of care practice intended to
develop work related skills and practice.

The organisation concerned with education, training, and workforce development for
social care, is Skills for Care. You should be familiar with their Code of Conduct, setting
out professional conduct and standards expected of all social care workers and
employers. There is a specific standard that relates to continuing education and
training and responsibilities of social care workers to keep themselves up to date.
You can find information about QCF standards and frameworks on these sites:
[Link] for [Link] Social Care in England
[Link] Northern Ireland Social Care Council
[Link] Scottish Social Care Council
[Link] Care Council, Wales
[Link] ‘Skills for Health’ was established in 2002 and was
supported by health departments of England,
Wales, Scotland and Northern Ireland, and
independent and voluntary health organisations
and workforces. It is now the Sector Skills Council
for Health, which as a responsibility for the UK
overall.
Independent Inspection bodies within the four countries of the UK make sure that all
care services meet the standards that those requiring care and support have a right to
expect.
[Link] Care Quality Commission are the independent
regulator of health and social care in England.
[Link] Scrutiny and improvement for Scotland.

[Link] Social Care Inspectorate for Wales

[Link] Social Care Inspectorate for Northern Ireland
Inspection bodies have a responsibility to check that organisations providing a care
service are doing so to at least the National Minimum Standards.

Regulatory bodies

The Care Quality Commission regulates health and social care in England. As well the
CQC there are other regulatory bodies such as, The General Medical Council (GMC)
and The Nursing and Midwifery Council (NMC).
Regulatory bodies protect the public, by ensuring that members work to a code of
conduct. They set standards in specific industries which professionals must adhere
to.

The CQC’s fundamental standards describe the minimum standards that all individuals
who access care services can expect. Some of the fundamental standards include:

• Person-centred care
• Dignity and respect
• Consent
• Safety
• Safeguarding

Employer’s responsibilities for knowledge and skills development

Under the Code of Practice, employers have a role and responsibility in relation to staff
training and development. They must provide opportunities for staff to develop skills
and knowledge, including organisational and vocational procedures and standards.

You need to be familiar with requirements that are the responsibility of your employer
to promote and ensure safe effective working systems and processes.

Employers must make sure that their staff are sufficiently experienced and trained to
meet the needs of the individuals requiring care and support.
Employees and the code of practice

This document identifies and describes standards that social care workers must attain
in their day-to-day work supporting vulnerable adults. Social care workers have a
responsibility to ensure they meet the standards in their work and contribute to
protection of individuals they support by employing safe effective practice. In relation
to your own training and development, the code states that social care workers must:
“Strive to improve the quality of healthcare, care and support through continuing
professional development”.

Being accountable for your practice

Being ‘accountable’ means that you have an obligation to carry out certain actions,
and that whether these actions have been carried out and whether they are to an
appropriate standard, can decide whether you have met your responsibilities to an
appropriate level.

For this reason, it is essential that you are fully aware of your contractual obligations,
and the role and responsibilities detailed in your job description.

Employers are also accountable to their employees – they must provide an appropriate
working environment, equipment and training so that staff can meet their
responsibilities safely and effectively.

Organisational policy

Every organisation should have policies and clearly defined procedures to ensure that
the employee’s rights to work related skills and knowledge development are upheld.
Each employee should be aware of what form this development takes and how they
access support and training.

1.2 The importance of reflecting on work activities

Roles and responsibilities

A role is a collection of related activities that is undertaken by an individual. It is

accompanied by an organised set of expected behaviours.

Roles in health and social care are shaped by organisation requirements and
individuals’ needs and expectations, and it is these that are used to create a specific
job description.

To fully explore your role within the care team it is important that you have a good
understanding of the job you are expected to carry out, the standards you must achieve
and who you are responsible to. Your job description should describe all aspects of
your job role, in detail. It is essential that you are very clear about exactly what is
expected of you and know when your responsibilities begin and end.

You may identify areas within your job description that concern you, or you feel you
need support with. If this is the case, it is imperative that you report this and discuss
your concerns with your manager. Alternatively, you may wish to discuss aspects of
your role, or responsibilities you develop over time, which do not appear in your job
description.

Reflective practice

Reflective practice is the process of reflecting / thinking about certain aspects of your
practice, to improve and develop your skills and knowledge. You may consider:

• What works well?

• What could be better?
• What could you do differently?
• How will you do things next time?

Reflection is an essential process in health and social care practice and, if applied to
all areas of your practice, will help you to think more closely about routine day to day
activities. Perhaps a small change in the way a daily task is managed could bring
about an improvement in the quality of care and support an individual is receiving.
Often it is too easy to become complacent and do things without even thinking about
them too much. It is relatively straight forward to learn from significant incidents that
can occur, but it is good practice to also think more closely about smaller and
seemingly less significant occurrences which can give a different perspective.

Understanding good practice

To be able to fully understand and appreciate the importance of good practice, it is vital
to be aware of the consequences of poor practice. Inevitably, the result of poor
practice will be the suffering of the individual, your work team and yourself.

To be judged as competent in your practice you must demonstrate a thorough

understanding of your role by:

• Applying theory and knowledge to practice

• Appropriate communication, attitude and understanding of values that underpin
practice
• Developing ‘reflective practice’ skills

You will need to develop analytical and evaluative skills to review your work, identify
areas that can be improved, and action plan your personal and professional
development as an ongoing process.

Skills analysis

There are probably many skills required of you. A detailed skills analysis will provide
you with an idea of what knowledge, practical skills and values are required to complete
aspects of your role effectively. Every skill requires practical expertise and knowledge.
Self-appraisal

This is the process of looking at your work role and giving your opinions and
judgements about your own performance in the workplace. This will probably be
carried out as part of an overall appraisal of your performance. Appraisal is vital to
identifying areas of practice that require improvement and aspects that you carry out
particularly well.

Your manager will complete their own appraisal of your performance and compare this
with your opinions.

1.3 Ensuring attitudes and beliefs do not obstruct quality of work

Values, beliefs and attitudes

Complex systems of values, beliefs and attitudes exist in all societies, directly
influencing the way people think, feel and behave. These are called ‘value systems’
and are vital for the making of choices and decisions. Value systems are frequently
incorporated into laws, rules and regulations, guidelines and organisational policies
and procedures. These are based on a belief of what is best for the people of that
society, workplace, educational establishment, religious organisation, care
establishment etc. Our aims and ambitions will be rooted in what we believe is right
or wrong. It is important that we develop certain values to be effective in our role as a
care worker.

Identifying value systems

Self-evaluation

Looking within oneself and examining, exploring and evaluating one’s own values,
beliefs and preferences is never easy, and may in fact be quite uncomfortable.

Exploring the way, we behave and interact with people requires an honest, self-critical
but positive approach.

We evaluate our value systems with feedback from others, as well as ourselves. When

identifying value systems, you and others may have identified certain beliefs,
values and preferences which may influence your care practice. It is important that
you accept and build on these. There may be aspects, such as empathy, compassion
and patience that you show to individuals because of certain factors that have
influenced your value systems. However, a self-
evaluation may uncover certain prejudices which affect
the way you relate to particular individuals, colleagues
and others. These need addressing and you will require
the support of your colleagues and manager to do this.

Diversity policy

All staff should be aware of their responsibility to accept

differences and treat everyone with equal respect.
The philosophy of care

Every care organisation should have a philosophy of care or a statement of its aims
and objectives. Alternatively, a policy or a mission statement may be available. This
should be displayed in a prominent position where all individuals, staff and visitors can
see it. This document will state exactly what standards of care the individuals should
expect and how the organisation aims to achieve this. These standards will be in line
with international, national and local legislation.

Learning Outcome 2
The learner will:
Understand how learning activities can develop knowledge, skills and understanding.
The learner can:
2.1 Describe how a learning activity has improved own knowledge, skills and
understanding.
2.2 Describe how reflecting on a situation has improved own knowledge, skills and
understanding.
2.3 Describe how feedback from others has developed own knowledge, skills and
understanding.

2.1 Improving practise through a learning activity

Reflecting on formal learning opportunities

For any training event or study day there is likely to be some written information given
out beforehand that outlines the event and identifies intended aims and learning
outcomes. These provide a useful introduction and can be reviewed at a later time.
Beforehand:
• Identify your learning needs
• What you expect to get out of the educational experience
• How you feel it would enhance personal and professional development

During the course you may find opportunities to discuss current practice issues with
colleagues and other professionals depending on the scope of the particular event:

• Any information you obtain should be collected – there may be printed material
available, or you should make your own notes
• Analyse how well the experience has met your learning needs and develop an
action plan as to how you can move on in your development

Example 1
When reviewing the information, you may identify:
• Specific ways in which the learning could be applied in your workplace within
organisational policy and procedures and providing feedback to your line
 manager is good practice. You may find that this course of action instigates
changes in your organisation
• Never take on board your own changes just because you consider them a good
idea but with support of your line manager and colleagues
• Changes in practice or working methods, can be monitored and their
effectiveness evaluated

Example 2
Having attended a study day on communication skills you can implement new
strategies for more effective communication into your practice immediately.
Example 3
The experience has triggered a specific interest for you, and you decide to carry out
your own research as a result.

Reflecting on journal articles

These could be on a variety of topics – practical skills, communication, legislation,

Codes of Practice – and it is advisable to keep a copy of the actual article. Remember,
always to identify your source.

2.2 Reflecting on how situations improve knowledge and practise

Throughout your career in care, as with your everyday life, you will encounter
unfamiliar circumstances and situations. How you deal with these will affect you and
influence how you feel about approaching a similar situation in the future.

In your work environment only, a few situations will have such an impact that they stay
in your memory. This is probably due to the strong feelings aroused at the time.

• You may have had a large involvement or been an observer

• You may have felt confident that you dealt with the situation well
• You may have felt inadequate, anxious, or frightened. If this is the case, it is
very likely that the situation has had a big impact on your practice ever since

Examples include:

• Medical emergency
• Other emergencies and accidents, e.g., a fire
• An individual passing away
• A violent incident
Using a specified system can enable competency in the skill of reflection. It is often
not an easy process to fully apply. The following guidelines can be helpful when
reflecting on day-to-day activities:
1. Describe the experience
2. Identify your thoughts and feelings
– Did you have the knowledge and skills required?
– Did you feel inexperienced?
– Did you feel confident?
– What do you think you did best when dealing with the experience?
– Do you think you could improve on your actions?
– To what extent do you think previous experience influenced your
actions?
– Do you think personal beliefs and attitude to work influenced your
actions?
3. Evaluate – by identifying what was good and bad about the experience
4. Identify what has actually been learned from the experience
5. Could outcomes be improved by taking different action in the future?

Beginning and maintaining a reflective diary

Keeping a record of your practice and how you think it
could be improved, is a way of monitoring your personal
and professional development. A reflective diary of this
nature can be used as an ongoing learning and
development opportunity.

2.3 How feedback from others develops knowledge, skills and understanding

Feedback from colleagues

It is often useful to discuss day to day issues with colleagues, and suggestions can be
made in a non-threatening manner and environment that may improve the outcome of
some of the things you are doing. Having a different perspective can often help to see
new and different solutions to problems or difficulties. It is a helpful way of reviewing
a particular situation.

Constructive feedback

Feedback is a valuable way of identifying what is done well, and other areas that need
improvement. To be useful it must be constructive, in that it is accompanied by
suggestions as to how improvements can be made. Feedback contributes to your
view of yourself and self-assessment. There are several different sources that may
provide you with feedback and it is useful to reflect on the circumstances around it.
If you feel you have done a good job day to day your ‘self-assessment’ would be
favourable and give you a sense of well-being.
Within your organisation you will be part of supervision or appraisal process, whereby,
with management, you review your progress and action plan for any improvements.
To be constructive, feedback needs to identify the positive as well as any development
needs.

Constructive feedback from others

The feedback you receive from others can help you to recognise your strengths and
weaknesses. Feedback may be received from several sources:

• Colleagues
• Individual
• Individual’s family members
• Other professionals
• Manager
• Visitors

Delivered honestly and in a non-judgemental, tactful way (focusing on your strengths

whilst also highlighting your weaknesses), feedback can be very constructive. It will
maintain confidence and allow you to build on existing knowledge and skills, therefore
improving the care delivered to clients. Areas for improvement can be identified and
used as a way to decide what you need to learn.

Evaluating feedback
Feedback from senior staff, such as managers and mentors, is vital. This may be
done formally during an appraisal, or informally during work activities and discussions.
Evaluation must take place with the support of supervisors. In turn, you must support
these people to evaluate how your new and improved skills and knowledge will
enhance your practice. Feedback is vital to the effective development of your practice.
Learning Outcome 3
The learner will:
Know how a personal development plan can contribute to own learning and
development.
The learner can:
3.1 Define the term “personal development plan”
3.2 Identify who could be involved in the personal development plan process.
3.3 Identify sources of support for own learning and development.
3.4 List the benefits of using a personal development plan to identify ongoing
improvements in own knowledge and understanding.

3.1 Defining the term “Personal Development Plan”

A personal development plan may have a different name but will record information
such as agreed objectives for development, proposed activities to meet objectives and
time scales for review and evaluation.
Identifying your own development needs

To improve and develop your practice and increase your knowledge, you need to
identify your development needs. To do this, you need to carefully explore many
aspects before you can plan your professional and personal development.
Recognising what experience, skills, and knowledge you have, will help you to prepare
a more detailed plan.

SWOT analysis

A ‘SWOT analysis’ is a way of exploring your own strengths and weaknesses and the
opportunities and threats that are present. This requires self-evaluation and an honest
approach.

3.2 Identifying who could be involved in the personal development plan

process
There are a number of people who could be involved in the personal development plan
process. These may include:
• The Individual
• Carers
• Advocates
• Supervisor, line manager or employer
• Other care professionals

Planning your personal and professional development

Prior to planning your personal and professional development, you will need to have
a clear picture of what your development needs are.

In order to develop your plan, you need to identify:

• The sources of and support mechanisms for skills and knowledge development:

- Educational opportunities, specialist courses and qualifications

- Employer’s training, learning whilst working, and learning from others.

• The planning of personal development:

- Producing a personal development plan which:

Builds on strengths
Addresses weaknesses
Addresses identified development needs
Recognises limitations of own role
Identifies sources of support
Identifies available learning opportunities
Includes realistic target dates and timescales
 • Evaluating the effectiveness of personal development:

- Ability to apply new skills and knowledge to work practice

- Appraisal
- Self-assessment
- Feedback from others (i.e., supervisor)

It is essential that you identify the support you require, both from within and outside
the care organisation. Planning can be undertaken by:

• Discussion, negotiation and agreement with the work team, manager, and other
key people. This is very important. You cannot undertake training, especially
if this involves members of the work team covering your work, without the co-
operation of the team. The team will also need to be agreeable to any extra
responsibilities or activities you wish to take on. You must discuss, develop,
and review, with appropriate people, the usefulness to your workplace of new
and improved knowledge and skills you wish to / have developed. Certain skills
and knowledge may be valuable to you, as a care worker, but of no use in the
care setting in which you work. Your professional development cannot
adversely affect the work team, as this may directly impact on the team’s ability
to meet the needs of individuals
• Identifying and balancing your development needs against the demands of your
work role and any personal commitments you have, is vital. Be realistic – goals
should be achievable – don’t take on too much
• Setting goals for yourself which are set at a level to suit you
• Focus on what you are realistically able to achieve, in relation to setting dates
and timescales
• Evaluating feedback from others, to improve future performance
• Recognising the limitations of your own role (certain learning opportunities may
not exist, e.g., if your role does not include administering medication, the
opportunity to learn and become competent in this skill, may not exist)
• Building on your strengths
• Minimising and resolving weaknesses
• Devising a Personal and Professional Development Plan
• Identifying learning opportunities, resources and support that exist in your
workplace
• Planning how and when you are going to study
• Working to overcome barriers to development

To overcome the barriers that you have identified:

• Ask for help, where this is needed

• Report discrimination
• Review goals and re-set if necessary. Look at time spans to
ensure that development is achievable within the time allowed
• Engage in honest, open communication
• Recognise constraints, discuss, negotiate and reach a compromise
• Do not over burden yourself. It is better to take on manageable development
that is achievable
3.3 Sources of support for learning and development
Sources of support may include:

• Supervision
• Appraisal
• Formal support
• Informal support
• Within organisation
• Beyond organisation

Supervision and appraisal

It is the responsibility of your manager to ensure you have access to training and
education.

The manager also has a duty to ensure you are supervised and are appraised
regularly. This is particularly important when using new knowledge and skills in your
work activities. A mentor in the workplace can support you and ensure all your
practices are safe and legal and are rooted in evidence-based research.

Appraisal

Feedback can be given formally, in the form of an appraisal. Appraisals of all staff
should be carried out regularly, usually annually. The appraisal will probably be
carried out by the manager, who should use this as an opportunity to discuss staff
development. Performance is reviewed and training needs discussed. It is important
that you maintain a positive attitude towards appraisal and use this to identify ways to
improve your practice. The appraisal will cover a number of areas including
competence, relationships with individuals and colleagues and punctuality.

Appraisals should never be used by management as a disciplinary tool.

Support and supervision

The support and supervision you require should be planned during appraisal. This will
include the forms of supervision and support required, how and when this is to be
provided, and who is responsible for its provision. Ideally, a mentor, who will guide,
support and assess you, will be allocated to you. This will enable you to have the best
possible opportunity to improve your practice.
Formal Support

Appraisal and supervision reports

Appraisal and supervision reports will highlight your responsibility for your
development, and you can discuss changes and challenges that have occurred or are
impending. Any possible issues or barriers that may arise can also be discussed.
You may be keen to identify what your career options and opportunities for promotion
are and plan short- and long-term goals with manageable objectives. Objectives are
specific steps you can take to achieve your goals:

• Specific
• Measurable
• Achievable
• Realistic
• Timed

You have identified aspects of your work that have gone well during the year and those
that have not gone so well. You have suggested training you think will support
development and ways in which you think needs can be met.

Informal Support

Accepting suggestions and ideas

Learning to accept suggestions and information offered by others constructively to

improve practice is a vital skill to learn.

Sometimes when others offer suggestions, it may seem as if you are being criticised
and told your way is ‘wrong’. You must, however, be open-minded and not take
offence. It is your duty to improve your practice. It may be that a senior staff member
/ manager / trained nurse suggests that working in a different way or undertaking a
training course would improve your knowledge and practical skills, and it would benefit
you and improve the care you give to individuals. This is, quite rightly, the collective
aim of the care team.

The way in which suggestions are made will vary between care organisations. Some
may adopt a formal, structured approach and others may discuss things informally
between colleagues and managers.

Using self-appraisal

Self-appraisal of your skills and work performance can be used, along with feedback
from others (either formally or informally) to identify any skills, knowledge and support
that will help you to become a more effective practitioner.
Recognising barriers to career development

There may be obstacles to your career development. It is vital that you can recognise
the reasons for these:

• Self-perception - lack of confidence may lead to you feeling you are not capable
or do not have the ability
• Lack of guidance and support – over worked and over stressed managers may
be unable or unwilling to devote the time required. Colleagues may be over
stressed, due to excess workload. They may feel unable to support others as
they feel inexperienced and unsupported themselves
• Work constraints -
- Staff shortages
- Shift patterns
- Working long hours – long hours and regular overtime can make
taking on extra commitments very difficult
• Other constraints -
- Family commitments
- Personal issues or problems, making it difficult for you to attend or
complete courses; never under-estimate the impact these
constraints can have. Taking on other activities may cause more
stress and make achieving goals extremely difficult
• Basic skills and learning difficulties
• Language barriers – we live in a multi-cultural society and it must be realised
that English is a second language for a great many people
• Discrimination – e.g., not allowing access to courses because a care worker is
older. Discrimination affecting individuals, colleagues and other key people

Support from within and beyond the organisation

Education and training

Education and training from a variety of sources contributes towards developing your
value systems and your care practice. Recognising the many types of sources of
education will enable you to decide what has benefited you and your individuals you
care for the most and help you to plan your learning for the future.

Specialist courses

These are courses which will provide you with a greater understanding of individuals’
needs and how they can best be met.

Health and safety training

Health and Safety training is vital in any workplace and will help to ensure that you, as
a care worker, take appropriate action to keep yourself and others safe and healthy.
Training resources of your organisation

Your organisation may have a carefully planned training and educational programme
of ‘in-house’ training courses which you will be expected to take advantage of. If you
are unsure or need advice, ask your manager or training co-ordinator. Remember that
trained and senior colleagues are an excellent educational and training resource,
which enables you to learn whilst you are working. Support and guidance will enable
you to become a safe and effective practitioner.

Network and support systems

Strong support systems and networks are vital to ensuring that individuals receive the
best quality care from a well-informed, well supported professional care team.
Colleagues within your care team and those teams that support the work you do (e.g.,
Primary Care Team, Catering Team, Maintenance Team etc) provide a network of
support, guidance and expertise during times of crisis and on an ongoing basis, to
enable care services to function effectively.

Keeping up to date

Monitoring developments in practice

It is important that all care workers keep themselves up to date. This may seem a
daunting task, as practice appears to change so rapidly. There are so many advances
throughout medicine and nursing, it is important that you concentrate on areas relevant
to your area of practice.

Introducing evidence-based practice

It is vital that you are able to discuss research knowledgably. This is particularly
important if you wish to introduce your new knowledge into your practice and influence
the practice of others. For many years, traditional practices were not researched;
people just assumed they were of benefit without any scientific evidence.

In the last 20-30 years, practices have been researched, which has resulted in some
being abandoned because either they were of no benefit or were, in fact harmful, e.g.,
certain lifting techniques.

Evidence based research has also shown practices that were previously abandoned
simply because they were thought to be ineffective or ‘old fashioned’, to be of benefit.
One example of this is the use of maggots to treat wounds such as leg ulcers and
pressure sores. It must be remembered that all research must be viewed carefully
and objectively, and evidence produced must be measurable and the results
consistent.

It must be recognised that although ideally all care practices should be developed
using evidence-based research, all ‘traditional’ practices must not be abandoned
unless evidence recommends that they are no longer used.
Ways in which you keep your knowledge and practice up to date may include:

• Technology – computers and related technology - involve medical equipment

and communications systems, hoists, beds, equipment to measure vital signs,
etc. temperature, pulse etc
• Approaches to working – prioritising, changes in ways of working, moves away
from task orientation
• Concepts, models and theories – holistic care; various models of nursing
• Strategies and policies – policies linked to legislation and guidelines impact on
the methods care workers use, e.g., moving and handling policy and procedures
• Legislation – directly affects strategies and policies, Health & Social Care Act
(2012)

Sources of information

These days, people quite rightly have high expectations of care services and the
people employed within them. Consequently, these issues are discussed and
reported in the mass media. This can be an extremely useful source of information
and may include:
• Television – news items and documentaries and educational programmes
• Radio – Radio 4 broadcasts programmes that cover a range of health issues
• Newspapers – ‘broadsheets’ such as The Times and The Guardian, have
columns written by health care professionals and in-depth reports about
development within the health services
• Publications – Professional journals are available from newsagents and
through local libraries. Your workplace may also subscribe to a particular
publication
• The Internet – an excellent source. Always ensure that information is
accurate by checking it has been approved by a UK professional body such
as the BMA (British Medical Association) or RCN (Royal College of Nursing).
This will increase the chances of information being reliable.

It is therefore vital to ensure that you take full advantage of the wide variety of support
available to you to enhance your own learning and development.
Safe practice

It is vital that you confirm with the appropriate people (e.g., manager, trained nurse
etc) that any ways in which you propose to apply new skills and knowledge are safe
and legal. A meeting with colleagues, with your manager’s permission, is advisable.
You cannot successfully apply new skills and knowledge on your own. It is also
valuable to have the opinions and ideas of others before you proceed. They may see
problems or solutions that have not occurred to you.

Improvements in practice

As part of your ongoing development, you must identify how the education and training
opportunities you undertake may improve your practice. This can take the form of a
reflective account for your learning diary – identify changes in knowledge and practice
you have made following these opportunities and explain how this contributes to
overall effectiveness.

Evaluating your personal development plan

It is important that the benefits of your personal development plan are evaluated.
Initially, you must evaluate whether you have the ability and the opportunity to apply
your new skills and knowledge to the workplace. This is an especially important first
step, as it is impossible to evaluate the benefits of your personal development plan if,
for whatever reason, you will be unable to apply your new skills and knowledge to your
work practice.

Appraisal

When you were identifying your personal development needs you obtained feedback
by means of an appraisal. This process helped you to plan your personal
development. Appraisal is advisable for the benefits of your personal development
plan to be evaluated and to assess whether the application of new skills and knowledge
to your work practice is realistic and will be supported.

Ideally, you should be supported with applying new skills and knowledge to your work
practice. However, there may be times, for several reasons, when this does not
happen. It is therefore important that you identify and undertake measures to address
this within your plan. You may need extra support from your manager or mentor to do
this.

Finally, it is important that you evaluate your plan by monitoring and reflecting to
ensure it is beneficial and effective.

3.4 The benefits of using a personal development plan to identify improvement

to own knowledge and practise.

Benefits to the care worker

The benefits of improved skills and knowledge to the care worker will impact positively
on the care organisation. These benefits may include:

• Increase in knowledge, skills and understanding leads to increased job

satisfaction and improvement in effectiveness of care and support
• Confidence in ability and competence when carrying out tasks and
communicating with colleagues and other professionals, individuals and
families
• Raised self-esteem and self-worth
• Changes in self-concept – sees self as a ’more able care worker’
• Raised awareness of best practice issues
• Raised awareness of poor practice and ‘whistle blowing’ strategies for
inefficient and unsafe practice
Benefits to the care organisation

There are many benefits to the care organisation as a result of improving staff skills
knowledge. These may include:

• Enhancement and extension of skills, resulting in the provision of more services

to individuals by the organisation
• Retention of staff as they have more commitment to an organisation that
facilitates their development and progression
• Enhancement of the organisation’s reputation attracting potential service users
and employees
• Financial benefits, as a skilled work force are better value for money
• Better education and support improve safety, resulting in less mistakes,
omissions and accidents. Reduction of ill health and injuries results in fewer
costly investigations and a lower number of complaints
• Less staffing problems, due to greater retention of existing staff and less
recruitment difficulties. Staff who feel valued and supported are more likely to
be reliable generally, and willing to help out in a crisis
• Individuals’ satisfaction increases where a skilled workforce is able to provide
the best care and services
• The organisation can meet legal obligations and adhere to organisational, local
and national guidelines, policies and procedures

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now complete the activities, workplace tasks and reflective journal before
proceeding onto the next unit.
Unit 3 Principles of diversity, equality and inclusion in adult
social care settings H/602/3039

Unit purpose and aims

This unit introduces the concept of inclusion, which is fundamental to working in adult
social care settings. This unit is aimed at those who are interested in, or new to,
working in social care settings with adults.

Learning Outcome 1

The Learner will:

Understand the importance of diversity, equality and inclusion

The learner can:

1.1 Define what is meant by:

• diversity
• equality
• inclusion
• discrimination
1.2 Describe how direct and indirect discrimination may occur in the work setting
1.3 Explain how practices that support diversity, equality and inclusion reduce the
likelihood of discrimination

1.1 Defining diversity, equality, inclusion and discrimination

In this unit we look at some of the key definitions and concepts associated with equality
and diversity. The unit then looks at the forces that work against equality, diversity,
inclusion and discrimination.

Defining diversity

Diversity means varied and different. So, when we talk about diversity in the place of
work or community, we are looking at how people differ from each other. We know
that everyone is an individual but what makes us all unique? Some factors are obvious:

• The way we look

• The way we choose to dress
• The way we behave
• Where we choose to live
• The type of work we choose to do
• The values we choose to live our lives by

All of these things make up who we are and affect how we lead our lives. But, when
looking at diversity, there are four main factors that are used to categorise the
population.
 • Age – the number of years that we have lived
• Gender – whether a person is male or female
• Class – the socio-economic background that you are from
• Ethnicity – a person’s race or ethnic background

Remember - ‘different is different’ not ‘different is wrong’.

Individuals from different backgrounds can contribute different experiences and this
enables us to learn about their culture, beliefs and experiences. In your role must you
have an open attitude towards diversity and respect individuals’ rights to have different
values, beliefs and cultures.

Defining equality

Equality means 'having the same importance and deserving the same treatment'. It
does not mean treating everybody the same, but it does mean giving everyone the
same opportunities and the same level of respect.

Equal opportunity means freedom from discrimination in areas such as education,

employment, housing, and healthcare. Discrimination means treating people
differently for irrelevant reasons, such as their gender, where they live, race, age,
religion, or sexual orientation, rather than judging people on their merits.

Schools, colleges, and universities cannot discriminate against pupils and students
because of any of the following protected characteristics; sex, race, disability, religion
or belief, marriage and civil partnership, sexual orientation, pregnancy, and gender
reassignment.

Pupils and students are protected from discrimination in the way they are to be offered
admission to schools, colleges and universities and in the way education and other
benefits or services are provided, and are also, in the case of disabled pupils or
students, schools, colleges and universities, are required to make reasonable
adjustments to allow the student or pupil to access to facilities and services.

It is unlawful for employers to discriminate against employees or potential employees

on the grounds of gender, race, marital status, disability, age, pregnancy and
maternity, gender reassignment and sexual orientation in deciding who to recruit or
promote, rate of pay, training offered or in the way they are treated in the workplace.
They are also under a duty to make reasonable adjustments to meet the needs of a
disabled employee/potential employee.

Anyone providing services to the public or a section of the public, and those who
exercise a public function (a local authority for example), including provision of
housing, are under a duty not to discriminate and in the case of a disabled person
have a duty to make reasonable adjustments to the person access to the services.

Defining Inclusion

Inclusion is defined as ‘accepting people’s diversity without discrimination in order that

they can participate in equal tasks’. Individuals who are actively involved in their care
and support are more likely to feel and be in control of their lives and this will contribute
to their overall well-being. Inclusion is also related to individuals having a purpose in
their lives and being accepted for who they are. They should feel valued and respected
and be encouraged to be an active part in their community.

Defining Discrimination

To discriminate or oppress is to treat people unfairly because of who they are, or

because they belong to a certain group of people. Whatever the reason, the intention
is to make people feel bad about themselves, and the effect is always negative.
Anyone may be discriminated against, but certain groups are more likely to be subject
to negative discrimination.

Racial Discrimination – implies that there is a normal way to be, promoting a fear of
differences in relation to race. This can lead to misunderstandings, which can develop
into hatred.

Gender Discrimination – suggests that one sex is better than the other and divides
the sexes.

Disability Discrimination – oppresses people with disabilities and suggests that they
are less important.

Religious discrimination – individuals may be discriminated against because of their

religious beliefs.

Discrimination based on people’s sexuality – individuals can be discriminated

against due to their sexuality.

1.2 How direct and indirect discrimination may occur in the work setting

Direct discrimination

Direct discrimination occurs when one person is treated less favourably than another
in the same or comparable circumstances. As well as words or acts of refusal direct
discrimination includes words or acts of discouragement. Examples may include:

Sheila is refused a promotion on the grounds that her employer is worried that she
may become pregnant and therefore cost them more, in maternity leave, than Bill her
co-worker even though they are equally qualified. This would be directly discriminating
against Sheila.

• An employee is not considered for promotion because of their age

• A job is refused to another person because of their disability
• An individual with dementia is prevented from participating in activities in a care
home because care workers believe the person will disrupt the session.
Indirect discrimination

Indirect discrimination occurs when a rule, condition or practice is applied that cannot
be met equally by everyone. There does not need to be any intention to do this by the
employer or service provider. The fact that the condition or requirement is in place is
enough to prove indirect discrimination. To succeed in a claim the claimants need to
show they are members of the protected group and that rules, conditions or practice
will put them at a disadvantage.

This could include:

• Refusing to allow employees to work flexitime where there is no business
requirement preventing this. This indirectly affects more women than men
because they are often the principal carers of young children.
• Insisting that all employees work on Saturdays. This indirectly affects those of
the Jewish faith because Saturday is their holy day.

There may be situations where an employer or service provider can justify the
provision, criterion or practice. To do this they must show that the requirement is a
proportionate means of achieving another aim, which is not discriminatory. For
example:

• Refusing to allow employee’s Saturdays off may indirectly discriminate against

people of the Jewish faith, but if the employees were employed as stewards at
a football stadium this can be justified as most football matches are held on
Saturdays.

Direct and indirect discrimination in care settings

Discrimination can occur for a number of reasons and in a variety of ways including:

• Misunderstandings about the culture and beliefs of others can lead to attitude
problems and care needs not being fully met
• Access to training and learning experience may be restricted especially if there
is a language barrier and no provision to overcome this
• Individuals may have their rights withheld, particularly their right to choose
• Opportunities to access and use resources and facilities may be limited
• Employment of care workers who are in any of the groups mentioned may be
affected. Care workers may be discriminated against by colleagues and those
they care for, creating tension which could lead to conflict or bullying.

Stereotyping – the meaning and effect

This is the process of making assumptions about an individual based on the group
which you feel they belong. The way in which we view certain sections of the
population leads to stereotyping. You may draw conclusions about their behaviour,
diet, beliefs, dress or even intelligence, based on unreasoned opinions.
Labelling – the meaning and effect

Labelling is to describe a person by the use of a ‘label’ or word which creates a certain
image and can give a negative impression of that person. The image the person has
of themselves can be affected and confidence and self-esteem can be lost. Individuals
who are labelled may have their rights withheld and the quality of the care they receive
may suffer. We may spend less time with individuals that we feel uncomfortable with,
or are even fearful of, because of the image we feel they project.

In a care setting this may affect:

• The way in which we relate to people

• How we communicate with them
• The quality of care they receive

Therefore, the way we speak about people and the opinions we form can directly affect
their experiences of the care sector.

NB - Positive Discrimination

You may have heard the term ‘positive discrimination’. This is different to discrimination
which oppresses people and leads to unfair treatment. The purpose of positive
discrimination is to allow people who are disadvantaged or are traditionally
discriminated against, to access opportunities, to have equality with those less
disadvantaged. For example, an educational institution such as a university may set
admission targets for entrance from state schools, ethnic minorities and those with
disabilities. The long-term goal being more access to higher education and an increase
in life opportunities for under-represented groups.

1.3 Practices that support diversity, equality and inclusion reducing the
likelihood of discrimination

Promoting good practice

It is also important to understand that the differences between racial groups should be
celebrated. Each different culture brings with it different skills and different ways of
looking at and solving problems.

An understanding of people’s differences

Individuals should be included in the planning and delivery of all aspects of their care.
This will ensure that the service provided puts the individual at the centre of everything
you do. Decisions are made and care is delivered with the individuals’ knowledge,
understanding, co-operation and consent. You, as a care worker, should actively
support individuals to participate as much as they are able to promote a sense of value
and worth.

Different people have different views on different sexual orientations. It’s fine that your
beliefs won’t always coincide with other peoples. After all you would never expect to
have the same views on religion or politics as the person sat next to you. What it is
important to take away from this section is that whether or not a person’s relationship
choices line up with your relationship choices it is their personality and their skills in
the workplace that affect their ability to do their job and nothing else.

For many people their main knowledge of increasing diversity comes from the media.
It has been well publicised that girls are now overtaking boys in many subjects at
school and that immigration into this country is increasing. But it is important that we
all understand the changes that are happening to the population of this country
because whilst urban areas may be mostly affected at the moment this will fan out.
Therefore, we will all have to embrace diversity and the benefits that it brings.

Valuing diversity brings benefits to people at work, in education, and the community
as a whole. Valuing diversity requires, respecting beliefs, values, religious practices,
food, dress and social etiquette of other people. Not behaving in ways which cause
needless offence and not misrepresenting or disparaging other people's beliefs and
practices.

Diversity and care

‘Variety, differences’

It is essential that care workers behave in a way which clearly demonstrates that they
accept the diversity of people and are not passing judgement. People have a right to
express and communicate their beliefs and views. We are all diverse individuals, with
differing personalities, skills, interests and talents and the benefits of this diversity to
individuals and society as a whole, must be acknowledged.

Support for culture, beliefs and values

Individuals have a right to receive care and support that allows cultural expression. It
is important to empower them to do this as it strengthens all aspects of their needs
and development. Maintaining contact with others, who have the same beliefs and
traditions, provides social opportunity and a sense of belonging and keeps them
mentally stimulated.

Aspects of culture can include diet, activities, personal care beliefs and preferences,
communication, care practice that impact on a daily basis - e.g., choice of gender for
a carer, actions in times of illness, dying and death. If there is no support for individuals
to satisfy cultural beliefs and values, then there would be no supportive relationships.
Values and beliefs are developed through life and can vary depending on family
traditions, background and experiences and growth and development. These are the
important issues in our lives that influence the way we behave and relate to people
and situations.

Professional and organisational values are the foundation of all care practice. Similarly,
an individual’s values and beliefs are what they base their lives on. You may have
experienced individuals who consider that their beliefs and values are the only ones
that matter and can be dismissive of others’ values because they are different.
The necessary support can be provided, providing you are familiar with preferences
of the individuals. It is important to know the history of a person as this can help
explain their present behaviour and attitudes. There is no need to carry out an
interrogation of the person and their families.

Talking to them and showing respect for their views and demonstrating active listening
skills will convey support. These actions empower the individual to be more confident
and boost self-worth and self-esteem. This in turn further consolidates the
professional relationship.

Support for cultural beliefs can be achieved by working as part of a team with
colleagues, passing on relevant information and by ensuring less experienced staff are
aware of factors that influence values and beliefs systems. These relate to diet,
customs, personal care, religious practice, dress, and socialising. It can create
difficulties if you are supporting a person who has strong negative views on race,
religion or behaviour. They are entitled to their opinions. However other people are
also entitled to their beliefs and to live their lives accordingly without the distress of
negative reaction from others. Alongside these rights go corresponding
responsibilities. When enjoying the right to uphold values and beliefs people have a
responsibility to ensure others can enjoy their rights and not be discriminated against.

There can be wide cultural differences within the areas of the United Kingdom so
awareness must not be solely focussed on individuals with origins in another country
or different religion. Regional differences can be quite marked and specific within our
country and these can relate to expectations, family involvement, aspects of language
and customs.

Person centred care

Person centred care is an approach that puts the individual at the centre of everything
you do. Therefore, all care revolves around, involves and includes the individual in
order to fully meet the needs wishes and preferences.

Holistic care

It is important that the whole care needs of the individual are met.
Care should be planned to take into consideration the spiritual,
psychological, and social as well as physical needs. This means
looking at the individual as a whole person rather than just focusing
on the medical condition. To provide holistic care and ensure
inclusion, it is important that care workers find out about the
individual’s needs wishes and preferences.

Encouraging individuals’ views to be expressed and listened to

It is important to understand how individuals in a care setting feel. There should be

systems in place to allow individuals to give feedback, both positive and negative. Care
settings should have regular meetings with individuals, their families and advocates to
ensure they are happy and to ask for their suggestions.
Suggestions may or may not be easy to implement, but will always be an insight into
the needs, wishes and preferences of individuals. Actions to implement agreed
changes should be seen to be taking place and individuals kept informed. Changes
may make a significant difference to individuals’ live, promote feeling of self-worth and
enhance relationships with care workers and other health professionals.

Empowerment

It is vital that individuals feel in control of their lives. Ensuring that they are aware of
their rights and choices, and that these are actively promoted with help them to be
confident and develop a feeling of self-worth. Individuals should be encouraged to say
what they want, express opinions, and make suggestions about the care that they
receive. This should apply to all individuals. Provision should be made to allow those
who have difficulty expressing their needs and wishes to make suggestions,
comments, and complaints, in order to prevent discrimination and promote equality
and inclusion.

Learning Outcome 2

The learner will:

Know how to work in an inclusive way

The learner can:

2.1 List key legislation and codes of practice relating to diversity, equality, inclusion
and discrimination in adult social care settings
2.2 Describe how to interact with individuals in an inclusive way
2.3 Describe ways in which discrimination may be challenged in adult social care
settings

2.1 Legislation and codes of practice

In the UK, serious efforts have been made to reduce discrimination and prejudice, and
the term ‘equality and diversity’ is commonly used. Legislation is in place to protect
people and reduce discrimination in many parts of our lives.

This legislation includes:

• Data Protection Act 2018 (protects the confidentiality of information)

• Mental Health Act 1983 and 2007
• Care Act 2014
• Equality Act 2010
• The Health & Social Care Act 2012
• Human Rights Act 1998
• Mental Capacity Act 2005
In relation to equality and diversity the Skills for Care Code of Conduct states that
social care workers must:

2, “Promote and uphold the privacy, dignity, rights, health and wellbeing of people who
use health and care services and their carers at all times

7, Uphold and promote equality, diversity and inclusion”

The Mental Capacity Act Code of Practice provides guidance on how representatives
act or make decisions on behalf of an individual who is unable to do so for themselves.
The individuals’ best interests must be at the forefront of the decision.

2.2 How to interact with individuals in an inclusive way communication and

interaction- being involved

An individual needs to talk, to be listened to, and to be involved with others. You should
consider what the best way is to communicate with each person you support.

In order to interact in an inclusive way, you, as a care worker, must accept the diversity
of individuals and not discriminate. All individuals have the right to be included, not
only in their care, but also in social activities, family life and be able to access and use
the services and resources of the community and the health care system. You, as a
care worker, must ensure that you inform and include the individual in all aspects of
the assessment, planning, implementation and evaluation of their care. You must also
encourage participation in family, social and community life and any activities
organised by and/or the care setting.

Inclusion and occupation – doing something meaningful

All of us need to feel actively occupied and included in the life we are part of. This
means knowing the difference between doing an activity, compared to being involved
and included in something that is meaningful to you as an individual.

Expressing needs and feelings

Every individual should feel that they have a right to express their feelings and
communicate their needs. As a care-worker, you must respond to this in a way that
shows you support their rights to this expression. It can be very easy for care workers
to take individuals comments personally, feeling they are being criticised, instead of
viewing comments as helpful and constructive.

Enabling inclusion

There may, however, be individuals who are unable to understand or fully participate.
It is yours, and the responsibility of other health care professionals, to ensure that all
individuals are interacted with in an inclusive way. Any barriers to communication and
inclusion should be identified and addressed by adapting communication to ensure
interactions are inclusive.
Interactions may need to be supported by aids and equipment, other health care
professionals, (e.g., speech and language therapists), social workers, signers for
British Sign Language, interpreters or advocates.

It is important for carers to involve the individual in all aspects of their daily life. By
understanding the individuals, wishes, needs, views, beliefs and culture shows you are
taking a genuine interest and a respectful approach to their care.

2.3 Describe ways in which discrimination may be challenged in adult social

care settings

According to Standard 7 of the Skills for Care Code of Conduct social care workers
must:

7.2 “not discriminate or condone discrimination against people who use health and
care services, their carers or your colleagues.

7.4 report any concerns regarding equality, diversity and inclusion to a senior member
of staff as soon as possible”

Challenging discrimination

By being aware and vigilant you can identify any assumptions, discriminatory remarks,
and other unacceptable behaviours immediately. Sometimes these may arise out of
ignorance not maliciousness and you have a responsibility to promote required
standards.

Discrimination must always be challenged when it occurs. This can be difficult,

especially if you are the only one making the challenge. Providing information such as
a Code of Practice or Policy explaining the discriminating practices that must not occur
will provide a clear pathway which empowers individuals to challenge discrimination
themselves when it occurs.

Educating and informing others who are discriminating against people is vital, as is
sending a clear message that discrimination is unacceptable and will not be tolerated.

The way in which you interact, uphold rights, give choices, and advocate for individuals
will enable you to act as a role model of good practice and set standards for others to
follow.

Action you should take should include:

• Sharing open and honest communication

• Trying to keep an open mind. We are all individuals. It is unfair to form opinions
about individuals based on ideas you may have about the group to which you
feel they belong
• Challenging people who stereotype and discriminate against others
• Think about the way people form opinions about you – would you prefer to be
judged by the group you belong to or by the way you behave, treat people and
do your job?
 • Challenging those who label or those who give care based on that label
• Putting the individual at the centre of everything you do

The message is clear, get to people as individuals.

Individuals, families, visitors, and those outside of the care organisation may
discriminate against other individuals, care workers and others. All discrimination must
be acted upon whoever is responsible for this. It is very wrong to allow an individual to
make discriminatory remarks or demonstrate discriminatory actions because they are
a service user or a relative. Discrimination is unacceptable and affects all those who
are subject to it, adversely. No care worker or individual should have to tolerate racist,
sexist, or homophobic behaviour from anyone.

Additionally, ‘turning a blind eye’ to avoid challenging individuals in your care (or
others) is not acceptable. You could be seen to be condoning discrimination simply by
not taking action to challenge this when it occurs.

Recognising and challenging discrimination in the workplace demonstrates that you

are developing skills and having confidence to challenge practices you see as not
acceptable.

Report any incidents to your manager and make a clear, accurate and legible record.
You may need the support of your manager and senior colleagues to challenge
individuals in an effective manner.

Learning Outcome 3

The learner will:

Know how to access information, advice, and support, about diversity, equality,
inclusion and discrimination.

The learner can:

3.1 Identify sources of information, advice and support about diversity, equality,
inclusion and discrimination
3.2 Describe how and when to access information, advice and support about diversity,
equality, inclusion and discrimination

3.1 Sources of information or advice and support on diversity, equality,

inclusion and discrimination

It is important to have a good knowledge of where to access information, so you are

in a position to support not only your individual but also yourself and colleagues within
the workplace. The Code of Conduct for Social Care Workers will provide you with a
list of statements that describe the standards of professional conduct and practice
required to complete your work role.
Your workplace policies and procedures will clearly explain the actions to follow
regarding diversity, equality, inclusion and discrimination and should include what to
report, when to report and how to report.

There should be open lines of communication between yourself and your line manager
or supervisor.
Agencies and resources who may assist you in supporting the rights of your clients or
others may include:
• Social Workers
• Community Nurses
• Primary Care Team
• Mental Health Teams
• Courts
• Interpreters
• Translators
• Internet
• Libraries
• Community Groups
• Charitable organisations such as Age UK could give you information or
handouts on equality, diversity, inclusion and discrimination
• Equality and Human Rights Commission

Advocacy

This is a process which enables those unable to fully exercise their rights, to have their
rights upheld. This is achieved by representation from a third party. The advocate
may be informal or appointed by the court. When you identify individuals, who may
be unable to exercise their rights, you may be in a position to speak on their behalf.
In certain circumstances this may not be possible, as it may be beyond your role and
responsibilities. You must then ensure that you discuss issues with your manager, who
will be able to arrange advocacy services. It may be possible to enlist the support of an
independent advocate to represent the interests of the individual. If there is conflict of
interests between the individual and the care team, an advocate can make the
individual feel they are being listened to and have someone on their side. This may
have the effect of taking the pressure off the individual and easing the tensions that
exist between them and the care team. This may result in the lines of communication
remaining open so that a solution, agreeable to all parties, can be reached.

3.2 How and when to access information advice and support about diversity,
equality, inclusion and discrimination
From the moment you start work in an adult social care setting, reading and
understanding the Codes of Practice and your workplace policies and procedures will
enable you to be aware of when and how to access information, advice and support
about diversity, equality, inclusion and discrimination.
It is vital that you as a care worker recognise that you have a ‘duty of care’ to all
individuals. The service you provide should be delivered equally and inclusively.
When to access information advice and support

Firstly, it is essential that you know the meaning of diversity, discrimination and
inclusion and the ways you can recognise diversity, promote inclusion, and challenge
discrimination.
It is equally important to recognise when you need to access information, advice, and
support. This may be because the information you require is difficult to locate or access
or you need advice and support to understand information or implement good practice
within your workplace.
Care workers may need to access information and advice if:
• You are having difficulty promoting diversity, equality, inclusion and
discrimination
• Knowledge and further clarification is required
• An individual or colleague requires further information.
This may be because some individuals have difficulty, knowing about, or asserting
their rights. This may be because they are not aware of these due to problems with:

• Health (physical or mental)

• Old age and frailty
• Understanding
• Language
• Literacy

Extra support
Occasionally. you may find that you are having difficulty supporting equality and
diversity. This may be for several reasons including:

• Difficulty in accepting and dealing with prejudices

• Lack of knowledge, understanding and experience in supporting equality and
diversity
• Lack of resources and / or support from colleagues / management / the
organisation

In order to ensure that people are treated equally and not discriminated against, it is
important that you seek the advice and support of appropriate people.

Sometimes the actions of others make it difficult to promote equality and diversity and
lead to conflict. Some people because of their beliefs, preferences, views etc refuse
to consider or show respect for others’ beliefs and values. Despite communicating
with them and identifying why their behaviour is not acceptable, some individuals may
choose to ignore the advice.
To ensure equality and diversity is enjoyed by all you must seek support of your line
manager or colleagues.
Take up chances of extra training in equality which could enable you to identify and
use effective strategies to improve your practice and those you support.
How to access information, advice, and support

Once you have fully understood when you need to access information, advice and
support, it is essential you know how to obtain this.
Initially, you will need to decide who you need to approach. This will usually be your
Line Manager who may be able to provide you with information, advice and support
themselves verbally, or written in the form of policies, procedures, and Codes of
Practice, which you should read to ensure you are clear about your responsibilities and
the steps you need to take. The manager may seek advice from, or refer you to, other
professionals who may be able to inform, advise and support you regarding diversity,
equality, inclusion and discrimination.
Monitoring, recording, and reporting of any problems with accessing information,
advice and support is essential to ensure individuals’ rights are upheld.
Complaints procedures
It is vitally important that individuals are not only provided with a Charter explaining
their rights and responsibilities, but that they are provided with information about how
to comment on care services and complain if they feel their rights are being withheld.
Information relating to how to make a complaint should be in a suitable format for all
individuals to access. This may need to be adapted to suit their needs, such as, an
audio copy, large print or in another language. Care workers should also be made
aware of the complaints procedure, to enable them to make a complaint themselves,
if they feel this is necessary, or to assist an individual to complain.

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now complete and upload the activities, workplace tasks and reflective
journal before proceeding onto the next unit.
Unit 4 Principles of Safeguarding and Protection in Health and
Social Care A/601/8574

This unit introduces the important area of safeguarding individuals from abuse. It
identifies different types of abuse and the signs and symptoms that might indicate
abuse is occurring. It considers when individuals might be particularly vulnerable to
abuse and what a learner must do if abuse is suspected or alleged.

Learning outcome 1
The learner will:
Know how to recognise signs of abuse
The learner can:
Define the following types of abuse:

• Physical abuse
• Sexual abuse
• Emotional/psychological abuse
• Financial abuse
• Institutional abuse
• Self-neglect
• Neglect by others

1.1 Identify the signs and/or symptoms associated with each type of abuse
1.2 Describe factors that may contribute to an individual being more vulnerable to
abuse

1.1 Types of abuse

It is essential that you, as a care worker, can understand what is considered to be

abuse and neglect. This unit will help you to recognise the signs and symptoms and
show you how to respond to these.

If you have experienced abuse you may wish to discuss certain issues with your
manager/supportive colleague, who will be able to arrange support for you.

To abuse is defined as - to ill-treat, use harsh words or insults

Physical abuse (intended harm on a person that causes injury, illness or harm)
• Hitting, slapping, pinching, biting
• Burning and scalding
• Starvation
• Torture
• Excessive cold or heat
• Overuse of medication
• Withholding food
 • Unlawful isolation – locking an individual in their room
• Unlawful restraint – e.g., preventing someone from getting out of bed using bed
rails.

Sexual abuse (Unlawful bodily contact of a sexual nature)

Individuals may be unwillingly subjected to:
• Direct sexual contact
• Exposure to or involvement in pornography
• Verbal sexual abuse

Emotional abuse (abusive actions that make an individual feel worthless and
humiliated)

• Humiliation
• Threatening behaviour (including verbal threats)
• Controlling and manipulating behaviour especially of those who are vulnerable
• Behaviour designed to produce fear or insecurity
• Being deprived of affection
• Denying an individual’s right to privacy, dignity and choice
Financial abuse (misuse of material or monies that belong to others)

• Theft
• Alterations to Wills
• Misinformation and deceit
• Misuse of benefits or pension
• Failure to protect those who are vulnerable

Institutional abuse (occurs when the setting focuses on the needs of the organisation
rather than the needs of the individuals)

This maybe by professional care workers or others in positions of responsibility.

Remember service users rely on care staff for their care. e.g., the relationship
between the individual and care worker is one where an uneven ‘power’ exists.

Institutionalisation
To nurture an individual’s rights, we must be aware of the pitfalls into which we can
slide. Here are some examples of poor practice:
• Regimented times for rising and retiring to fit staff schedule
• Forced into routines to suit care workers
• Lack of dietary choice
• Restricted visiting times
• Unable to lock bedroom door or own cupboard
• Lack of integration within the community
• Lack of choice and decision making
These are all examples of institutionalised practices and have no place in a modern
care environment. Institutionalisation may occur when individual’s needs, desires and
rights are not recognised.
The individual may:
• Lose the ability to exercise their rights
• Become over dependant on the care worker
• Lose independence and freedom
• Be fearful of making the decisions which lead to self-management.
• Lose identity – sense of self

Institutional practices are never acceptable and care workers must report these
practices and encourage and assist clients to complain. It is your responsibility to
ensure that junior colleagues do not participate in these practices and are supported
to report any concerns.

Neglect by others

Neglect – defined as failure to take proper care of or fail to do something

Failing to provide:
• Basic physical or emotional needs
• Food
• Warmth
• Shelter

This can also include not providing support for an individual’s cultural and religious
needs.
Failure to give or obtain:
• Shelter and warmth
• Sufficient food
• Medical help when this is needed
• Adequate physical care
• Help to attend to personal hygiene
• An environment that is clean and hygienic
• Medicine or care that has been prescribed
• Company
• Creative and emotional stimulation
• Help to manage finances
• Affection and attention
Self-neglect through the individual’s vulnerability

This can occur when a person is unable to fully attend to their needs. This can be due
to physical or mental health problems or disability.

This can occur due to the person being unable to:

Attend to and maintain personal hygiene
Keep a clean environment
Maintain a safe living environment
Buy food or prepare meals
Understand or carry out medical advice
Understand and manage finances

Self-neglect through individual’s choice

This means that, for whatever reason, a person chooses to neglect themselves.

They may choose:

To live in a dirty and unhygienic environment
Not to attend to personal hygiene
To have a poor-quality diet
To take safety risks that may affect the individual and others.

Individuals may be unwilling to:

Obtain or follow medical advice

Take control of finances

1.2 Signs and symptoms of abuse

Physical abuse
• Being reluctant to explain injuries
• Unexplained bruises
• Unexplained marks which leave imprints of fingers, hands, or a belt buckle
• Injuries which occur as the result of frequent “accidents”
• Flinching in the presence of a carer or others
• Covering up marks and not wanting support with personal care

Sexual abuse
• Genital infections or sexually transmitted diseases of unknown origin.
• Repeated urinary and genital infections
• Unexplained bruises around the thighs, buttocks, breasts and genital area.
• Unexplained bleeding stained or torn unclothing.
• Withdrawn
• Aggression or suggestive sexual behaviour
Emotional abuse
• Noticeable, unexplained changes in behaviour
• Becoming withdrawn, anxious or losing confidence
• Avoiding physical contact
• Showing fear
• Deterioration in mental or physical condition with unexplained cause
• Change in eating and or sleeping habits

Financial abuse
• Excessive worries about money - unsure about state of finances
• Unusual shortage of money
• Missing pension or bankbooks

Institutional abuse
• Inadequate food, drink, or heating
• Lack of adequate or appropriate clothing for example, the wearing of a thin
summer dress without a coat in freezing temperatures
• Dirty living conditions
• Difficulty in gaining access to the individual
• Absence of dentures, hearing aids, spectacles, or prosthesis (false limbs).
• Low self-esteem, anxious, angry, upset.
• Rigid routines
• Lack of choice

Neglect

• Excessive dirt or odour

• Injuries that may be caused, or shown openly, this could indicate self-abuse
• Malnutrition
• Dehydration
• Weight loss
• Dirty or unsafe living conditions
• Feeling confused, low in mood, anxious, withdrawn
1.3 Factors that may contribute to an individual being more vulnerable to
abuse

Anyone can be a victim of abuse. Certain individuals, however, are at risk due to their
physical and emotional vulnerability.

Risk may be defined as:

High Risk Medium Risk Low Risk

1. Those who are physically 1. Individuals who are 1. Individuals who are
and mentally impaired physically impaired physically well
2. Individuals needing help 2. Individuals who are 2. Those who are
with everyday tasks such mentally impaired mentally alert and
as feeding, dressing and 3. People who are frail are able to express
toileting themselves.
4. Those suffering
3. People with dementia, or confusion and 3. Those who are fully
behaviour that suggests issues with mobile and
a need for almost communicating independent
constant supervision
5. Individuals who are 4. Those who are self-
4. Individuals with low not entirely self- caring
mobility
caring
5. Those dependant due to
reasons of age
6. Those suffering sensory
deprivation e.g., sight or
hearing impairment
7. Individuals who have a
specific communication
difficulties

It is important to realise that these are only risk factors. They are not a definite
indication of who will be abused and who will not. It is important that you, as a care
worker, are aware and use your skills to detect potential or actual abuse.

Below is a list of factors that may affect or contribute the individual being more
vulnerable to abuse:
• Disability
• Loneliness
• Lack of awareness
• Some people have had a bad experience of help in the past. These people
may refuse help.
Other factors

Individuals who have specific conditions such as dementia and mental health needs
may be unable to recall what has happened or may experience hallucinations and
false beliefs. Therefore, may not be believed by others. Individuals with poor mobility
may be frail and unable to defend themselves.

Poverty
Individuals may have to make choices between
food, heating, cleaning, and housing. It may look
as though someone is not looking after themselves
properly. They may look thin; their clothes may
not be clean, and they may not be able to afford to
care for themselves properly.

Predisposing factors
Predisposing factors can vary depending on the type of care service and facility they
are receiving – nursing or care home or a domiciliary setting. In a nursing or care
establishment the following issues could increase the risk of abuse, harm or danger to
residents:
• Poor physical environment and conditions of employment
• Isolation of staff and residents - Little outside contact with visitors
• No stimulating activities or events
• Poor supervision, support and monitoring of staff by those in senior positions
• Poor induction and training for the job role – or no induction or ongoing training
• Failure to provide guidance and standards
• Failure to consider individuality
• Too strict or too casual management practice
• Staff who lack commitment, knowledge and skill
• Failure to carry out sufficient recruitment checks and procedures
• Poor communication
• Challenging behaviour from individuals

Risks in domiciliary setting – working with families who are primary carers:
• Family carers taking on the role out of guilt or obligation to the individual
• No support to enable appropriate care
• Lack of appropriate resources
• Isolation
• Poor housing conditions
• Financial, personal and health problems
• Challenging behaviour from the individual being cared for
• History of abuse within generations of the family e.g., domestic violence, child
abuse
In addition, the home setting may mean that none of those caring for the individual
have a formal duty of care, any guidelines or accountability to an employer,
organisation or professional body.

Learning outcome 2
The learner will:
Know how to respond to suspected or alleged abuse

The Learner can:

2.1 Explain the actions to take if there are suspicions that an individual is being abused
2.2 Explain the actions to take if an individual alleges that they are being abused
2.3 Identify ways to ensure that evidence of abuse is preserved
2.4 Actions to take if there are suspicions that an individual is being abused by a
colleague, someone in the individual’s personal network, your line manager or
others within the care establishment
2.5 Actions to take if an individual alleges, they are being abused by a colleague,
someone in the individual’s personal network, your line manager or others within
the care establishment

Suspicions and complaints of danger, harm and abuse must always be reported. If an
individual tells you, they are being abused, or have witnessed others being abused,
you cannot promise to keep this secret and must make it clear that you have to report
the allegation. This can then be dealt with at management level and decisions and
action taken, where necessary.
Abuse is a crime. You must tell a manager because they can do something about it.
Tell the vulnerable adult you will tell the manager. Write down in the notes that you
have told them this. It is your manager’s job to find out what the vulnerable adult wants
to do about the abuse. You must show courage as it is your duty of care to protect the
individuals you are caring for.

If you suspect abuse, remember:

• Write it down
• Keep a copy
• Talk to your manager

Reporting:
• You must report if you see abuse
• You must report if you hear about abuse
• You must report if you think someone has been abused
• You must report abuse straight away
• You must make sure the vulnerable adult is safe
• You must tell the manager
• Don’t ask questions. Your manager will do that
• Try to do what the vulnerable person wants if you can
• Support the vulnerable person at all times
Supporting those alleging abuse
It is essential that those who disclose abuse are supported and believed. The fear of
not being believed, as well as fear of the consequences of disclosure, may be reasons
why people are reluctant to report abuse / neglect. Love and loyalty to family
members, and the abused person feeling they are in some way responsible for the
abuser’s actions, can prevent disclosure.
Abuse and neglect must not be tolerated, whatever the circumstances.
All reports, allegations and suspicions, must be taken seriously.
Being confronted with a situation involving abuse or neglect can cause great anxiety
and fear, whether you are the victim of the abuse or neglect, the person to whom abuse
is disclosed, or the person suspecting or witnessing abuse. Your employer has a duty
to protect you, individuals, and others from abuse, so you should be supported,
whoever is involved, and whatever form the abuse takes.
The care organisation must have clear policies and procedures about handling
suspicions and allegations of abuse and must be aware of the multi-agency adult
protection arrangements for their locality.

Support provided should include:

• Information about the complaints procedure must be provided, verbally and in
writing
• Support should be offered during examinations and interviews
• The individual must be kept informed of procedures at all times
• Full access to legal services should be made available. Other agencies, such
as advocacy services, social services and counsellors may be required.
• Listen to the individual and be non-judgemental at all times

The client, should, at all times, be free from the fear of:
• Most importantly - facing their abuser
• Reprisals
• Discrimination

Certain undertakings can be given to those who disclose abuse or neglect, whilst
others cannot. You can reassure the client that:
• They are believed and will be supported throughout
• That the abuse or neglect will be reported
• That action will be taken (the client can be informed that a full investigation will
take place)

There are certain reassurances that you, as a care worker cannot give to a client or
others, concerning the outcome of a complaint of abuse / neglect. These will include:
• You must not promise to act in a way which is beyond your role or
responsibilities
 • You cannot predict what the outcome of an
investigation will be, or what punishment any
proven abuser will receive
• You must not suggest that any financial
compensation is guaranteed, or indicate a
figure

The Manager will refer the abuse

It is important to write everything down:

• The manager will fill in a Safeguarding Adult Referral

• The referral form and the notes may be needed later. They will be needed for
legal reasons. They may be needed if someone is dismissed
• The manager will keep a copy
• The manager will forward the form to either:

- Police
- CQC (Care Quality Commission)
- Social Services – adult services department of your local authority

• The manager will ask them to say they are dealing with the referral
• The manager will write in the company records that they have sent the form

It is important that in addition to:

• Colleagues
• Someone in the individual’s personal network
• Others

Suspicions and allegations of abuse may be made against:

• The learner (you, the care worker)

• The Manager

It is vital that you respond appropriately whoever is involved. Obviously, if allegations

or suspicions involve your line manager you need to obtain advice about who you
report to. In a large organisation there may be more senior staff, owners, or trained
staff other than your immediate manager. However, if there is no one else senior to
the manager available to you then you may need to report to the Care Quality
Commission, Social Services or the Police.

You, the care worker may be suspected of or have allegations of abuse made against
you. No abuse is acceptable, and all allegations must be investigated. However, it is
important that you obtain advice and legal representation. This will ensure you are able
to answer the allegations giving your account in a fair and balanced way. You must
also understand and be kept informed of investigations and actions throughout.
Making records
Initially the contact you make to report abuse may be verbal, but it is very important
that a written record of the nature of the complaint is made. This should be done
whatever the eventual outcome is. Your manager may ask you to write an account or
may record your comments. It is advisable that you make your own written record,
especially if this is not done at the time. All entries must be accurate, legible and
complete. Records should be factual and objective, to ensure they are a true reflection
of the events that occurred. This will protect all those involved from abuse either being
ignored or false accusations being made.

2.3 Identify ways to ensure that evidence of abuse is preserved

Evidence
It is important to ensure that any evidence is not contaminated, or unduly influenced,
so that the allegation can be investigated fairly.
The care worker must not influence the person’s recall of the incident (avoid putting
words into the mouth of the abused or alleged abuser)
• No reference to personal opinions should be disclosed or voiced to the
individual
• Injuries may need to be photographed, before, after or during treatment
• Never divulge any details to those who do not have the right and need
to know. Seek advice from your manager if you are unsure

Verbal and written reports should be legible, accurate and complete, and signed.
Any physical signs of abuse or neglect should be preserved (this may involve
discouraging bathing or washing, until examination is carried out by a doctor). Broken
items or personal possessions could be used as evidence so leave the environment
how you found it. Try to limit the amount of people in the environment so finger and
footprints are preserved. You should inform your manager or the police if you have
moved or touched something that might be relevant.

Learning outcome 3
The learner will:
Understand the national and local context of safeguarding and protection from abuse

The learner can:

3.1 Identify National Policies and local systems that relate to safeguarding and
protection from abuse
3.2 Explain the roles of different agencies in safeguarding and protecting individuals
from abuse
3.3 Identify reports into serious failures to protect individuals from abuse
3.4 Identify sources of information and advice about own role in safeguarding and
protecting individuals from abuse
3.1 National and local policies and systems relating to safeguarding and
protection from abuse
There are acts of parliament and national/local policies/systems, relating to the
protection of everyone in society, that affect us all. These include laws governing
physical or sexual assault, threatening behaviour and verbal abuse.
The powers of the police and social services are governed by acts of parliament. These
are both general and those specific to care and include the following legislation:
• Human Rights Act 1998
• Safeguarding Vulnerable Groups Act 2006
• The Care Act 2014
• Data Protection Act 2018 & GDPR
• Health and Social Care Act 2012
• Equality Act 2010
• Mental Health Act 1983 and 2007
• Mental capacity Act 2005

National Policies include:

• Safeguarding Adults: National Framework of Standards for Good Practice and

Outcomes in Adult Protection Work 2011
• Deprivation of Liberty Safeguarding (DOLS) 2008
• Dignity in Care 2006

Policies and procedures of the care organisation

The policy and procedures of your organisation will clearly state what both the
employee and employer’s responsibilities are concerning abuse. These will be in line
with legislation, local and national policies and systems. It is important that you make
sure that you are aware of these.

The responsibility for developing and implementing procedures for dealing with
danger, harm, abuse and neglect will rest with the management. Your organisation
must have a policy and procedure for identifying and reporting abuse and neglect. You
need to make yourself aware of these.
Work responsibilities will be influenced by organisational procedures which determine
each care worker’s role in the process of alerting and reporting abuse.
You need to be aware of your responsibilities towards your clients and your employer.
There will be general definition of employees’ responsibilities, and certain
responsibilities expected of individual employees.
Other local systems may include multi-agency adult protection arrangements.
Statutory agencies, such as the police and social services, must follow procedures
defined by law. These will affect the entire process from receiving the complaint to
investigation and any subsequent criminal procedures.
3.2 Roles of different agencies in safeguarding and protecting individuals from
abuse

The Care Quality Commission (CQC)

The Care Quality Commission (CQC) is the organisation that oversees and inspects
how care providers operate. They give licenses to adult health and social care
providers, if they meet essential standards of quality and safety. Their inspectors visit
and look at how people are being cared for, to make sure that essential standards are
met, and regulations followed. They have the power to close any home or agency if
they find bad practice.

Police

Adult Protection Investigators and all police officers are responsible for protecting life
and preventing crime. They will have policies and procedures relating to handling alerts
about abuse, running investigations and how they coordinate with the other agencies.

Safeguarding Adults Boards

They work with agencies in local authorities to ensure that effective systems are in
place for safeguarding and protecting individuals from abuse. They encourage
agencies to work together and share best practices.

Voluntary Agencies

Action on Elder Abuse, whistle-blowing helplines and other voluntary agencies provide
independent advice and support for individuals, families and workers with regards to
safeguarding and protection abuse.

The Disclosure and Barring Service

The Disclosure and Barring Service (DBS) was set up because of the Protection of
Freedoms Act (2012) and came into effect in December 2012. The primary aim of the
DBS is to help employers decide whether an employee is suitable to work with
vulnerable adults. The DBS provide a service which checks whether an individual has
a criminal record. This helps an employer decide whether they would be suitable of
working within their organisation. The DBS can also check a “barred list” to see if a
person is automatically barred from working with vulnerable adults.
The DBS is a merger of the previous Criminal Records Bureau (CRB) and Independent
Safeguarding Authority (ISA), and the function it performs is the same. The service
performs the following tasks:
Disclosure

The DBS searches police records and, in relevant cases, barred list information, and
then issues a DBS certificate to the applicant and employer to help them make an
informed recruitment decision. The DBS introduced a code of practice for recipients of
a DBS certificate, which means information on the certificate is handled sensitively and
with care.

Referrals

Another role of the DBS is to prevent unsuitable people from working with vulnerable
adults and children. An employer or organisation can make a referral to the DBS if they
think a person has caused harm or is a risk to a vulnerable person.

Barring

The DBS is responsible for barring people who are unsuitable for working with
vulnerable adults. Being on a barred list can have serious consequences for the person
involved as it can affect their employability and severely restrict the type of work they
can do. However, since the protection of vulnerable adults is vital, this means the DBS
have to have clear procedures in place when deciding whether a person’s name should
be on the barred list. There are two main ways that potential cases for barring come
to the DBS:
Automatic barring: a person may have been cautioned or convicted of a “relevant
offence”, for example, someone with a conviction for abusing a vulnerable adult will
be automatically barred.
Referrals: Some organisations (such as local authorities, NHS trusts) have a legal duty
to make referrals to the DBS if they have dismissed an employee from work following
harm to vulnerable adult, or when they feel there is a risk of harm in the future. The
DBS then decide whether the individual should be placed on the barred list.

Who must be checked?

As a general rule, people who have access to vulnerable adults must be checked if
their role is to carry out a regulated activity. This means the focus is now on what
activities are carried out with the vulnerable person, rather than where it is carried out.
Anyone who is carrying out regulated activities needs a check, regardless as to
whether they are paid staff or a volunteer. Regulated activities include:
• Healthcare
• Personal care
• Assistance with cash
• Social work
• Assisting in conduct of own affairs by appointment
• Conveying adults between places where they will receive healthcare, social
work or personal care, when arranged by a third party
Controlled activities include cleaning, cooking, record keeping or other jobs which do
not directly give access to vulnerable people. Under the new regulations, there is no
longer a requirement to check people doing “controlled activity”. This does not mean
that someone doing a controlled activity will not be asked to be checked, it will depend
on their role and how much exposure they have to vulnerable adults.
The UK coalition government scrapped plans for a safeguarding scheme which
“registers” people who are working with vulnerable people. It is, however, still an
offence for someone on a “barred” list to apply to work with vulnerable people and also
an offence for an employer to employ a person who is on the list.

Your part in protecting vulnerable adults

Your duty as a worker or volunteer in care is to know how to treat vulnerable adults
with respect, preserving their privacy and dignity. You must be aware of actions that
could cause unintentional neglect and you must watch out for situations where this, or
abuse, may be happening. If you are worried that you have seen vulnerable adults
being treated without respect, or without care for their health or safety, you must tell
someone. The best person to tell is your manager.
You will be asked to write down what you saw or heard, and your manager will
investigate. If necessary, they will tell the local council, the NHS, or the police. If the
investigation results in a suspension, or would have done but the person leaves, then
a referral must be made to the DBS.

Whistle blowing

This means to report unsafe or illegal work practices. Whistle-blowers will receive
protection and as a result of reporting concerns your employment rights will not be
affected. If you don’t feel able to tell your manager, then you can take action yourself.
You must do this in good faith and be able to make a good case: you cannot just
accuse someone without good reasons. Your local authority will tell you about ‘whistle
blowing’ and what to do. You can do directly to the Care Quality Commission by
telephoning or emailing them your concerns.
Summary
It is illegal for anyone who has been barred to apply for a position caring or supporting
vulnerable adults.
There are lists of people who have criminal records and who have been reported for
harming vulnerable adults in some way. The lists must be checked for anyone who
wants to work closely with vulnerable adults, whether paid or unpaid. They must be
checked to see if people are safe to be employed. This includes agency staff and
volunteers. Only people who have received ‘safe’ results back from the DBS can care
for or work with vulnerable adults.
Any evidence of wrongdoing must be reported, and the person referred to the DBS,
even if they leave.
Other agencies who can be contacted regarding information on safeguarding and
protection are:
• National Policies regarding safeguarding – under these policies information is
available on safeguarding training
• Employer/organisational policies and procedures – give the employee detailed
guidance on how to protect and safeguard all individuals within the workplace.
• Local authority Adult Services Department – Safeguarding team who
investigate reported incidents of abuse and ensure safety
• Police can investigate and prosecute if necessary
• Carers Direct helpline – can give the carer advice on all reporting procedures

3.3 Reports into serious failures to protect individuals from abuse

Sadly, safeguarding systems sometimes fail to protect vulnerable adults and children.
Occasionally, a major case of serious safeguarding failures will be publicised through
the media. The investigations that follow often lead to a collection of failures that
contributed to the death, injuries and serious abuse and suffering.

Case 1
‘Baby P’ was abused and killed by his mother and stepfather, despite the involvement
of multiple agencies which were supposed to protect the toddler. Failures of systems
and professionals involved were highlighted in Lord Laming’s report published on the
12th of March 2009 which made 58 recommendations all of which were accepted by
the then Children’s Secretary, Ed Balls.

Case 2
As a result of failings in care, Mr B, who had schizophrenia, suffered deteriorating
health and living conditions and was unable to care for himself. The Ombudsmen
report, 5th July 2011, found that the 5 Boroughs Partnership NHS Trust and St Helens
Metropolitan Borough Council failed to monitor Mr B and respond to signs that he was
at risk. They also failed to deliver the standard of care to which Mr B was entitled,
implement the care plan and manage risk appropriately. The recommendations were
that the Trust and the Council apologise and pay compensation to the family and their
legal costs. The Ombudsmen asked for the two bodies to produce an action plan
setting out what they will do to prevent other vulnerable people being let down in the
same way in the future. The Trust and the Council have agreed to all these
recommendations.
3.2 Sources of information and advice about own role in safeguarding and
protecting individuals from abuse

The policies and procedures of your organisation will clearly state what both the
employee and employer’s responsibilities are concerning abuse. It is important that
you make sure that you are aware of these.
Other sources of information are:
• Local Authority, Adult Services Department
• Manager
• Internet
• Books
• Care Quality Commission
• The Disclosure and Barring Service
To reduce the risk of abuse and neglect, and to monitor those at risk within your
organisation, it is important that you have the skills to do this. Training is provided
within the workplace; learning ‘as you work’, guided and supported by senior
colleagues.

Learning outcome 4

The learner will:

Understand ways to reduce the likelihood of abuse

The learner can:

4.1 Explain how the likelihood of abuse may be reduced by:

• working with person centred values
• encouraging active participation
• promoting choice and rights
4.2 Explain the importance of an accessible complaints procedure for reducing the
likelihood of abuse

4.1 Reducing the likelihood of abuse

Person-centred values

Person-centred care is an approach which aims to help you and other care workers to
see, value and treat people as individuals requiring dignity and respect who have led,
and are still leading their own unique life.
Consequently, as a care worker, it will help to think about the person first, i.e., their life
history and what they enjoy, and the condition second. If as a care worker you can
look behind the condition and see the person, then this will help you to consider how
you can help the individual.
Person-centred care was developed in the 1990s by, among others, the late Professor
Tom Kitwood, of the Bradford Dementia Group. (“Dementia reconsidered – the person
comes first” Kitwood, 1997).

The five key elements of person-centred care

Professor Kitwood identified five key elements of positive care. It is important that you
think about an individual’s previous whole life and what was and still is important to
them.
These include:
• Comfort and attachment – belonging.
• Communication and interaction
• Biography and identity – their past, who they are.
• Autonomy and Agency – being in control.
• Inclusion and occupation – doing something meaningful.

Individuality

All people, whether or not they are receiving care have their own needs, desires,
beliefs and rights – this is what makes us all individuals.
The needs of each individual must be specifically tailored to their individual needs.
Most receiving care would rather that they were fully independent and care workers
must apply the basic care values, to ensure service users do not become
institutionalised.

Identity

Some of the ways to ensure that service users are treated as individuals include:
• Encouraging decision making
• Offering choice
• Respecting privacy
• Enabling them to control their own lives.
• Recognise and value the individuality and uniqueness of the person.
• Calling individual by the name they prefer
• Making time to actively listen and talk to the individual.
• Finding out and respecting individual’s beliefs
• Finding out how to enable individuals to satisfy their beliefs.

Everyone has the fundamental right to define their own identity. All the above points
will enable the person to develop a greater sense of self-worth.
Rights

In all care settings, individuals have rights, which include legal rights and the right to
equality of opportunity. Some of these rights will be identified in policies, charters and
documents drawn up by the care organisation.
Although all of us have rights, the law can take away some of these rights if you are a
danger to yourself and/or others. There is sometimes a conflict between people’s
rights. For example, some people need to be admitted to hospital under the Mental
Health Act (some of their rights are taken away) because they are a danger to
themselves and others.
One of the basic human rights is to be listened to. Each care home, or organisation,
should have a written way of dealing with complaints.
Many people in a care setting keep quiet because they are worried that people at the
home might dislike them for complaining and make their life more difficult.

Choice and Independence

The right to choose is a basic human right. Some people have much more choice than
others.
Promoting choice is fundamental to good care practice - it is something that is
emphasised in a range of charters and organisational policies.
The right to make choices is also linked to a person’s identity. What you choose to
wear or eat, how you choose to live – these depend partly on economic circumstances,
i.e., how much money you have.
Everyone is entitled to full and thorough information in order to make an ‘informed
choice’, as to what they want/need. You may need to adapt how information is
presented to an individual to ensure you are meeting their needs. For example,
providing information in picture format, audio, Braille or using objects of reference.
Most people would prefer to be independent. However good the care is, the person being
looked after may lose a degree of independence and freedom.

Privacy

Some individuals may want to keep their rooms as private as possible.

They may want others inside the room, except a particular care worker and then only
at certain times.

Individuals have the right for their information to be kept private and only shared on a
need-to-know basis.
Respect and Dignity

It is very important that you show respect for individuals and value their individuality.
By doing so, it promotes confidences and individuals are more likely to speak up for
themselves. When providing personal care, it is important that the individual feels safe
and comfortable for example, closing curtains and covering an individual with a blanket
or towel.
The care package should reflect, by referring to the individual name, what a person
prefers to be called (Mr, Mrs, Mary etc.) addressing someone as ‘love’, ‘mate’, etc. can
be insulting to them. Your attitude and approach should be positive; not negative. Tone
of voice is important; the way you talk to an individual.

Partnership

It is important that you, as a care worker, build a trusting relationship with individual.
Always treat them and their home, (or room, if they are in a care home), with respect
and resist the urge to ‘take over’. Ensure their rights and choices are upheld, always
maintaining a pleasant and willing attitude. This will prevent the individual from feeling
they are a burden.

Active participation

Active participation is a way of working that recognises an individual’s right to

participate in the activities and relationships of everyday life as independently as
possible. The individual is regarded as an active partner in their own care or support,
rather than a passive participant.
Individuals should be included in the planning and delivery of all aspects of their care.
This will ensure that the service provided puts the individual at the centre of everything
you do. Decisions are made and care is delivered with the individual’s knowledge,
understanding, co-operation and consent. You, as a care worker, should actively
support individuals to participate as much as they are able. Active participation results
in mutual respect and encourages care workers to see individuals as decision makes
and people in their own right.

Promoting choice and rights

We all expect that we have a right to choose. Being cared for does not alter this right.
A client does not lose all ability to do things for themselves or make choices, just
because they become ‘a client’. It is important to maintain individuals’ chosen daily
activities, maintain their physical activities and keep the body exercised.
• Mentally – it keeps the mind alert.
• Emotionally – it provides stimulation, interest, a sense of self-esteem and
individuality.
• Socially – it keeps contact with others and maintains social skills and identity.
These may include:
• Choosing recreational activities
• Choosing diet and fluids
• Having visitors
• Having a say in how the care setting is organised and the care they receive.
• Choosing hygiene facilities and standards
• Choosing to care themselves.
• Communicating using their preferred method and language

4.2 The importance of an accessible complaints procedure for reducing the

likelihood of abuse.
It is vitally important that individuals are not only provided
with a Charter explaining their rights and responsibilities, but
that they are provided with information about how to
comment on care services and complain if they feel their
rights are being withheld. Care workers should also be
made aware of the complaint’s procedure, to enable them
to make a complaint themselves, if they feel this is
necessary, or to assist a person to complain. It is important
that the complaints procedure is easy to access, understand
and use. The format of the complaint’s procedure may need to be adapted to meet the
needs of individuals. For example, an audio, braille, or large print version.

Learning outcome 5
The learner will:

Know how to recognise and report unsafe practices.

The learner can:

5.1 Describe unsafe practices that may affect the well-being of individuals.
5.2 Explain the actions to take if unsafe practices have been identified.
5.3 Describe the actions to take if suspected abuse or unsafe practices have been
reported but nothing has been done in response.

5.1 Unsafe practices that may affect the well-being of individuals

Unsafe practices may lead to adverse consequences for the individual and directly
affect the individual’s well-being. Unsafe practices may include:

• Poor working practices

• Resource difficulties
• Operational difficulties
Poor working practices
All individuals in a care setting may be adversely affected by poor working practices,
but this will be particularly so for vulnerable individuals who have a high level of
dependency and may be unaware of or unable to question poor practices or make a
complaint. Poor working practices can involve all aspects of care needs and affect
physical, mental/emotional, spiritual, and cultural wellbeing. These practices may
include:

• Not adhering to, or having lack of knowledge of health, safety and security
guidelines, legislation, and policies, including:

- Unsafe moving and handling techniques and use of banned lifts.

- Incorrect use and/or maintenance of equipment
- Failure to use correct equipment.
- Poor infection control techniques
- Incorrect use/failure to use PPE.
- Unsafe handling of medicines
- Failure to adhere to COSHH.
- Failure to take care of personal and other’s
security and not adhering to policies and
procedures.

• Not meeting individual’s care needs

- Poor observation monitoring and reporting

- Not responding to symptoms/requests for help and poor control of
symptoms e.g., pain
- Inappropriate use of restraint
- Failure to prevent development of pressure sores.

• Not meeting mental health/emotional/spiritual/cultural needs

- Poor communication
- Failure to respect individual’s rights
- Institutional practices
- Discriminatory practices
- Failure to identify and meet emotional, spiritual, and cultural needs.
- Failure to respond to concerns, complaints and allegations or suspicions
of poor practice/abuse /neglect.
(This list is not exhaustive)

Resource difficulties
These may include:
• Lack of aids or equipment
• Difficulties with accessing policies or procedures.
• Lack of access to training
• Inadequate staffing levels including inappropriate skill mix.
• Inappropriate or unsuitable accommodation or fixtures or fittings
• Financial difficulties of the organisation
Operational difficulties
These may include:
• Poor management of staff and resources
• Inadequate support of managers
• Conflicts of interest between staff, individuals, and others
• Lack of continuity of care due to the use of temporary/agency/inexperienced
staff due to organisation’s recruitment or absence procedures
• Inadequate response to difficulties/concerns/complaints
• Poor leadership
• Absence of written policies and procedures

5.2 Actions to take if unsafe practices have been identified

It is vital that when unsafe practices are identified these are acknowledged and
addressed immediately to prevent adverse consequences. Whatever the underlying
factors contributing to unsafe factors the first step is to report your concerns.
The Skills for Care Code of Conduct 1.9 states that social care workers must:
“report any actions or omissions by yourself or colleagues that you feel may
compromise the safety or care of people who use health and care services and, if
necessary, use whistleblowing procedures to report any suspected wrongdoing”.

Action 1
Report your concerns to your manager, initially, who should take these seriously and
act on them. If no action is taken, then you should report and seek the advice of the
Care Quality Commission. It is advisable to make a written record in case you need to
refer to this later on.

Safety and the workplace

The workplace should be a safe and secure place to be. Work should be carried out
in a way that promotes safe and healthy practice. All staff should be aware of who is
in the building and who is with individuals, at all times. The whereabouts of all staff
should be known, and every member of staff should know how to summon help in an
emergency. Ensure you are aware of your responsibility.
Management should ensure a good staff to individual ratio and provision is in place for
staff sickness and holidays to prevent excessive use of agency staff.
The care organisation should provide suitable accommodation/buildings, resources,
aids and equipment to enable care workers to practice safely.
The policy and procedures of your organisation will clearly state what both the
employee and employer’s responsibilities are concerning abuse. These will be in line
with legislation. It is important that you make sure that you are aware of these.
Work responsibilities will be influenced by organisational procedures which determine
each care worker’s role in the process of alerting and reporting abuse.
You need to be aware of your responsibilities towards individuals and your employer.
There will be general definition of employees’ responsibilities, and certain
responsibilities expected of individual employees.

Good practice
To ensure that you are aware of and practice in a safe professional manner you must:
• Ensure you are familiar with and know legislation and organisational policies
and procedures and where information on these can be accessed.
• Be well informed of the kinds of issues that could lead to abuse or harm in your
setting.
• Be aware of signs and symptoms that could indicate abuse in your setting.
• Speak up if you feel certain practices do not adhere to these guidelines and
Acts.
• All organisations require a ‘whistle blowing’ policy with which staff should be
familiar. This enables all staff, not just seniors and management to speak up
and challenge dangerous, abusive or discriminatory practices.

Self-awareness
Looking at the way that you behave towards individuals and others is vital to ensure
that your practice and relationship with others, reduces the risk of abuse and neglect.
Treating people as individuals, showing respect, maintaining privacy and dignity in an
open and honest environment, will help individuals and colleagues to feel secure
enough to trust you to communicate concerns about actual or likely danger, harm, or
abuse.

Protection policy
A policy should provide definitions of what is meant by harm, danger, or abuse and
this would relate specifically to the service user group involved. Any adult who
receives care and support of a service is by nature of that need, vulnerable so
procedures should be written accordingly.
The procedure details how the policy is to be put into practice. This includes
identification of signs and symptoms, monitoring concerns, risk assessment, promotion
of prevention and verbal and written reporting.

Security
The workplace should be a safe and secure place to be. Work should be carried out
in a way that promotes safe and healthy practice. All staff should be aware of who is
in the building and who is with individuals, at all times. The whereabouts of all staff
should be known, and every member of staff should know how to summon help in an
emergency.
By working to guidelines and procedures you can recognise difficulties or likely
problems early and take appropriate action that minimises risks and provide protection.
You need to be aware of how to balance individual rights and responsibilities with
health and safety restrictions.

Observing individuals at risk

The importance of careful observation of all individuals, their visitors and all those
involved in their care, cannot be overstated. This will help to reduce the risk of abuse
taking place.

Monitoring
It is essential that once an individual has been identified as at risk from abuse, that
monitoring takes place. Almost anyone can abuse others. It is important that you
recognise who potential abusers may be. It is equally important that you keep an open
mind, and do not have a set idea of who may abuse, as this may cloud your judgement.
The available evidence and the contact by potential abusers will establish the level of
risk and determine the monitoring that takes place.
The care team, working in partnership with the individual, the representative (where
this is appropriate) and other agencies should agree on a level of monitoring that
protects the individual, but also recognises that the person has rights and needs.
Developing a relationship of trust will enable individuals and key people to
communicate concerns about abuse, harm or danger to themselves and others.
Certain individuals, such as those who self-harm or are considered suicidal, will require
a high level of monitoring and this may restrict the freedom of movement. If the risk
of suicide or self-harm is extremely high and the individual is diagnosed as having a
serious mental health problem, they may be receiving treatment whilst detained under
a section of the Mental Health Act 1983. This level of monitoring would require a high
ratio of staff, as very frequent checking of the individual would be essential. A
structured plan with set time intervals for checking the individual at risk, by a
designated member of staff, will be recorded on documentation designed for this
purpose.
Those on the ‘at risk’ register will be monitored according to Social Services plan. This
would be in accordance with legislative requirements associated with the individual,
and the risk identified. It is more likely however, that monitoring will take place as
specified in the plan of care. The level of risk and the type of care environment will
determine when, how and where monitoring takes place.
The information you give must be accurate, detailed, complete, and confidential.
Statutory agencies, such as the police and social services, must follow procedures
defined by law. These will affect the entire process from receiving the complaint to
investigation and any subsequent criminal procedures.
It is essential to safety and security that you seek information about your specific role
in protecting individuals from actual or likely danger, harm or abuse. Your manager
will be able to provide guidance and advice.

5.3 The action to take if suspected abuse or unsafe practices have been
reported but nothing has been done in response
If you have followed your organisations’ policies and procedures to report suspected
abuse, neglect, operational difficulties or unsafe practices, no action has been taken
and you have received no support from your management you must contact the Care
Quality Commission who will be able to advise and support you. Social Services may
also be able to support and advise you.

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now complete and upload the activities, workplace tasks and reflective
journal before proceeding onto the next unit.
Unit 5 Introduction to Duty of Care in Health, Social Care or
Children’s and Young People’s Settings H/601/5474

Unit purpose and aims

This unit is aimed at those who are newly commencing or plan to work in health and
social care settings with adults or children. It introduces the concept of duty of care
and awareness of dilemmas that may arise where there is a duty of care.

Learning outcome 1

The learner will:

Understand the implications of duty of care.

The learner can:

1.1 Define the term ’duty of care’.

1.2 Describe how the duty of care affects own work role.

1.1 Defining ‘duty of care’

Duty of care is an important part of your role and it underpins everything you do in your
job. You do not just have a duty of care to the individuals you support but also their
families, visitors, your colleagues, and other professionals you may work with. As an
adult care worker, you have a legal and moral obligation to have duty of care. This
includes:

• Acting in the best interests of individuals and others

• Protecting them from harm
• Promoting individuals’ well-being
• Working within the agreed scope of your job

1.2 The effect of the duty of care on the care worker’s role

The Code of Practice is based on the care worker’s duty of care and will affect every
aspect of their role, as each care activity will require the care worker to demonstrate a
duty of care to the individual and those significant to them.

The care worker also has a duty of care towards colleagues and their employer, who,
in turn, have a duty of care towards the care worker.

Skills for Care Code of Conduct for Healthcare Support Workers or Adult Social
Care Workers in England. There are 7 standards which you must adhere to:

1. Be accountable by making sure you can answer for your actions or omissions.
2. Promote and uphold the privacy, dignity, rights, health, and wellbeing of people who
use health and care services and their carers at all times.
3. Work in collaboration with your colleagues to ensure the delivery of high quality,
safe and compassionate healthcare, care and support.
4. Communicate in an open, and effective way to promote the health, safety and
wellbeing of people who use health and care services and their carers.
5. Respect a person’s right to confidentiality.
6. Strive to improve the quality of healthcare, care and support through continuing
professional development.
7. Uphold and promote equality, diversity and inclusion

Holistic care

It is important that the whole care needs of the individual are met. Care should be
planned to take into consideration the spiritual, psychological, and social as well as
physical needs. This means looking at the individual as a whole person rather than
just focussing on their medical condition.

To provide holistic care and fulfil the duty of care it is important that the care worker
finds about the individual’s needs, wishes and preferences.

Maintaining individuality

It is the right of each person to be treated as an individual. This will make them feel
valued and respected. You, as a care worker, can achieve this by the way you treat
your individuals:

• Always find out the name they prefer to be called. Do not assume everybody
prefers first name terms, or endearments such as ‘gran’ (this may be seen as
belittling to the individual)
• Talk with and listen to individuals, key people, and others to assess, needs,
wishes and preferences.
• Find out about the individual’s daily routine, their family and friends, hobbies,
and interests.
• Plan care holistically
• Be polite, helpful and show empathy.
• Ensure individuals have contact with family and friends.
• Encourage personal items, e.g., photographs, furnishings, ornaments etc
• Do not clothe individuals in items that belong to the care establishments.
• Encourage the wearing of day clothes.
• Give choices, uphold rights.

Privacy and dignity

The Human Rights Act and the Health and Social Care Act 2012 state that a person
has a right to privacy, dignity, and respect.

Privacy may be viewed as privacy of information, the provision of private areas for
individuals and privacy that involves covering the body.
All individuals have the right to be provided with a private area to wash, dress, attend
to toilet needs, meet with visitors, receive treatment, relax or be alone.

Clothing should be of the individual’s choice and should

cover the body adequately to maintain dignity. Individuals
should also be offered advice and support to choose
clothing appropriate for their personal needs and the
activities they are undertaking. Care workers can show
respect and preserve dignity by always supporting
individuals’ choices and upholding their rights, being
polite, patient, and helpful. An abrupt, impatient, or
intolerant attitude will humiliate and dehumanise the
individual and should be considered abusive. Care
settings where care practices are institutionalised, do not
maintain dignity, privacy or show respect.

Confidentiality

Confidential – to be kept secret – entrusted with secrets.

As a care worker you are in a very privileged position, as during the course of your
work, you will be entrusted with some very personal or highly sensitive information
about people.

Individuals in a care setting are owed a duty of care from care workers. This means
that you have a duty to act in a professional way and protect the confidentiality of
information you gain in the course of your work.

Breaching confidentiality – the consequences

Individuals may lose trust in their care worker. They may mistrust not only you but your
colleagues and other care professionals. This may mean that they will not reveal things
the care team need to know to provide them with the best quality of care.

Secondly information may be misused and result in the individual being treated badly.
Conflict may result as they feel hurt and betrayed.

Breach confidentiality and you are not meeting your duty of care.

The right to choose

We all expect that we have a right to choose. Being cared for does not alter this right.
An individual does not lose all ability to do things for themselves or make choices, just
because they become ‘a client’. It is important to maintain an individual’s chosen daily
activities, maintain their physical activities and keep the body exercised.

• Mentally – it keeps the mind alert.

• Emotionally – it provides stimulation, interest, a sense of self-esteem and
individuality.
• Socially – it keeps contact with others and maintains social skills and identity.
 • These may include:
• Choosing recreational activities
• Choosing diet and fluids
• Having visitors
• Having a say in how the care setting is organised and the care they receive.
• Choosing hygiene facilities and standards
• Choosing to care themselves.
• Communicating using their preferred method and language

Life is far more pleasant, and the time spent in each other’s company far more
rewarding, if people feel valued and respected. Forming a good relationship will help
individuals socially, mentally, and physically. Good, honest, and open communication
with people creates a positive, therapeutic atmosphere, and high standards of care
reflect this.

Empowerment

It is vital that people feel in control of their lives. Ensuring individuals are aware of their
rights and choices and that these are actively promoted will help individuals to be
confident and develop a feeling of self- worth. Individuals should be encouraged to say
what they want and make suggestions about the care they receive.

Diversity and care

Diversity is defined as – variety, differences.

All people must be treated with respect and receive the equal rights to which they are
entitled. Recognising and respecting the diversity of people is vital. It is unfair to
discriminate against someone because they are different to our idea of ‘normal’.
Indeed, any form of unfair discrimination by a care worker would be viewed as a failure
in the duty of care.

Learning outcome 2

The learner will:

Understand the support available for addressing dilemmas that may arise about duty
of care.

The learner can:

2.1 Describe dilemmas that may arise between the duty of care and an individual’s
rights.
2.2 Explain where to get additional support and advice about how to resolve such
dilemmas.

2.1 Dilemmas that may arise between duty of care and individual’s rights

Dilemma is defined as: a difficult choice between two decisions.

Dilemmas and Conflict of Interest

There may be dilemmas, conflicts of interest, or restrictions, which make it difficult at

times to meet individuals’ rights.

Staffing levels – An individual may wish to go out at a time when staffing levels are
low and staff may be engaged in providing care which has to take priority.

Health and Safety issues – An individual may not wish you to use a hoist to move
them, even though they are unable to bear their own weight. They may expect that
you lift them without the hoist, although you must not do this.

Choices of others – An individual may be used to choosing the TV programmes they

prefer to watch and expect others to allow this. This can cause tensions, as other
individuals may be having their right to choose withheld.

Individuals’ responsibilities

It is important to acknowledge that individuals have rights, and every effort must be
made to inform them of their rights and strive to uphold them. It must not be forgotten
that with every right comes a responsibility. For example, it is an individual’s right to
change their mind or to refuse certain aspects of care. However, it is also their
responsibility to accept the consequences of their choices or actions.

Certain individuals, due to their own vulnerability, may not be able to fully exercise their
rights or understand or be responsible for their actions, and may need to be protected
by law (e.g., by the Mental Capacity Act 2005 or the Mental Health Act 1983).

You, as a care worker, have a duty of care towards individuals. It is the responsibility
of all the care team to ensure that individuals obtain their rights and are aware of their
responsibilities and choices.

Individuals may at times make, what care workers believe, are unwise decisions which
may adversely affect their health and well-being. This may be because they do not
fully understand the implications of their choice or, in some circumstances, may be
making informed choices, despite fully understanding the consequences.

Conflict and failure to agree

It is possible that differing perceptions of needs can occur. This can happen when the
individual does not perceive their care needs in the same way as the care team does.
There may be many reasons for this. It may be that the individual does not understand
or may be in denial. Alternatively, they may not perceive the problem to be as severe
as others view it and may be reluctant to accept the help offered. The service user
may feel that they are losing their independence or that people are interfering.

It is essential to resolve any conflict that may exist, so that the care programme can
be agreed. Conflict between individuals, their family and the care team can create a
barrier which can affect relationships. It is vital to always keep lines of communication
open! It is essential that the individual appreciates that the care team understands the
choices they make, and that they do not make any judgements about their choices.
Clear information should be given in respect of what can realistically be offered.

If an agreement cannot be made, the individual should be clearly informed that the
team cannot agree to anything that presents an unacceptable risk, and that they must
understand the consequences and take responsibility if they wish to continue without
interventions to remove or reduce the risk.

There are several ways in which problems can be overcome and it is essential that all
members of the care team show the individual respect and support.

• Ensure the individual has all the necessary information to enable them to make
informed choices.
• Give clear explanations of the consequences of failing to take advice with
regard to identified risks.
• Modify communication so the individual understands (e.g., explaining
something in a different way)
• Actively encouraging the individual comments and suggestions therefore
promoting empowerment and the right to choose

All these issues may cause dilemmas for a care worker who feels they are unable to
fulfil their duty of care and are concerned about balancing choice with risk.

Balancing individual choice with risk

Individuals may self-neglect due to their vulnerability and it is very important that health
care professionals become involved if that risk becomes so great that the health, safety
and well-being of the individual and others is put at risk.

Individuals who self-neglect through choice have a responsibility to those around them.
They are not entitled to make choices that put others at risk. Social Services and other
agencies must become involved to protect all those involved.

It is important that you understand this, as you have a duty of care to all individuals
and a responsibility to others. You must report concerns to your manager.

2.2 Obtaining additional support and advice to resolve dilemmas

Avoiding dilemmas

Dilemmas can be avoided by:

• Developing a trusting relationship

• Always ensuring that needs are met promptly and in full.
• Listening to your individuals
• Ensuring that communication is open and honest.
• Maintaining a pleasant attitude
Resolving conflict:

• Identifying what the causes are

• Listening to both parties
• Helping both parties to reach a mutual agreement to resolve the situation.
• Any worries your client has, that you are not able to help with, may require more
specialist help. Your manager will be able to arrange this.

A dilemma may also occur when care workers are aware that certain working practices
conflict with the rights and choices of individuals. However difficult taking action may
be, as a care worker you must not adopt these practices yourself and must report your
concerns, in order to fulfil your duty of care.

Standard 1.9 of the Skills for Care Code of Conduct states that care workers must:

“report any actions or omissions by yourself or colleagues that you feel may
compromise the safety or care of people who use health and care services and, if
necessary, use whistleblowing procedures to report any suspected wrongdoing”.

Although your manager will be able to advise and support you to resolve dilemmas, it
is important you know how to get additional support.

Advocacy

It may be possible to enlist the support of an independent advocate to represent the

interests of the individual. If there is conflict of interests between the individual and
the care team, an advocate can make the individual feel they are being listened to and
have someone on their side. This may have the effect of taking the pressure off the
individual and easing the tensions that exist between the individual and the care team.
This may result in the lines of communication remaining open so that a solution,
agreeable to all parties, can be reached.

Support services

Other agencies who may assist you in supporting the rights and resolving dilemmas
include:
• Social Workers/Social Services • Interpreters
• Community Nurses • Translators
• Primary Care Team • Community Groups
• Mental Health Teams • Charitable Organisations
• Courts • CQC
Learning outcome 3

The learner will:

Know how to respond to complaints.

The learner can:

3.1 Describe how to respond to complaints.

3.2 Identify the main points of agreed procedures for handling complaints.
3.1 Responding to complaints.

Comments, complaints and compliments

It is important that individuals and key people know they are entitled to complain, or
indeed compliment, the care they receive. Information should be given both verbally
and in writing to ensure that the individual and key people are aware of, and
understand the procedure for complaining, complimenting, and challenging the content
of their care plan and standard of care, within your care organisation. If
communication is open and honest, and relationships between individuals, those
significant to them and the care team are good, comments regarding care should be
encouraged, discussed openly, and responded to positively.

Complaints procedures

It is vitally important that individuals are not only provided with a Charter explaining
their rights and responsibilities, but that they are given information about how to
comment on care services and complain if they feel their rights are being withheld and
the organisation has failed in its duty of care. Information relating to how to make a
complaint should be in a suitable format for all individuals to access. This may need
to be adapted to suit their needs, such as, an audio copy, large print or in another
language. Care workers should also be made aware of the complaints procedure to
enable them to make a complaint themselves or to assist individuals to complain.

Standard 2.10 from the Skills for Care Conduct states that care workers must:

“always take comments and complaints seriously, respond to them in line with agreed
ways of working and inform a senior member of staff”.

The most important responsibility you have is to report any complaints to the
appropriate person, which will probably be your manager, a trained nurse or person
taking managerial responsibility.
3.2 Agreed procedures for handling complaints

The most important aspect of handling complaints is to ensure that all complaints are
taken seriously and responded to promptly by the care organisation. Management
should:

• Reassure the individual that the complaint is being taken seriously and will be
responded to appropriately and promptly.
• Give the individual verbal and written information about the complaints
procedure.
• Listen to the individual carefully.
• Give clear information and explanations. This will clarify any queries or possible
misunderstandings that may have contributed to the complaint.
• Where possible resolve any issues to the satisfaction of the individual
• Instigate formal complaints procedures in accordance with organisational policy
and procedure, where this is considered necessary due to the nature of the
complaint.
• Make a written record. This must be done even if the complaint does not lead
to a formal complaints procedure.

Policies and procedures of your organisation will clearly state what both the employee
and the employer’s responsibilities are concerning the complaint. These will be in line
with legislation. It is important that you ensure that you are aware of these. The
responsibility for developing and implementing procedures for handling complaints
rests with management. The organisation must have a procedure for dealing with
complaints and supply relevant information to individuals and care staff.

The information you give must be accurate, detailed, complete, and confidential.

Any statutory agencies, such as the police and social services must follow procedures
defined by law. These will affect the entire process from receiving the complaint to
investigation and any subsequent criminal proceedings.

Entries into certain documents may include:

• Documents kept by the organisation.

• Individual’s care / nursing notes
• Complaints forms
• Incident forms
• Witness statements

Doctors will record in medical notes. The police and social services will have their own
documentation, if their involvement is considered necessary.

Even if you are not asked to record your report it is wise that you make your own record
of the complaint/incident. This will help you to remember details if you are asked for
these. In addition, this may also provide protection for all those involved, including you.
Information included should be:

• Accurate
• Legible
• Complete
• Signed

Entries

These should contain all the details of the complaint/incident including:

• Names of all those involved.

• Dates
• Times
• Place
• When reported and to whom?
• The nature of the complaint/incident
• Consequences, including physical injury and psychological effects.
• Action taken during and after incidents / complaints.
• Evidence available – e.g., physical injury, environmental damage, damage to
clothing or personal effects
• Referral/reporting to other agencies

Records and confidentiality

Any records made by the care worker must be submitted to the appropriate person,
without delay.

Confidentiality must be maintained. Records should not be left where those without a
right to, can access them. Any discussions about the nature and content of the records
should take place in private, so those without the right and need to know, cannot
overhear.

Records should be stored securely and access limited.

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now complete and upload the activities, workplace tasks and reflective
journal before proceeding onto the next unit.
Unit 6 Understand the Role of the Social Care Worker
A/602/3113

Unit purpose and aims

This unit is aimed at those who are interested in, or new to working in social care
settings. It provides the knowledge required to understand the nature of working
relationships, working in ways that are agreed with the employer and working in
partnership with others.

Learning Outcome 1
The learner will
Understand the working relationships in the social care settings.
The learner can:
1.1 Explain how a working relationship is different from a personal relationship.
1.2 Describe different working relationships in social care settings.

1.1 Working and personal relationships

It is vital that as a care worker, you can differentiate between working and personal
relationships. A care worker, who has a friendship with his / her manager, must not
expect any special privileges and must behave in a manner expected of all workers of
the same grade.
The manager must not give preferential treatment to the care worker or expect the
worker to accept responsibilities beyond his / her role, or not to complain if problems
arise within the workplace.
Alternatively, workers may have little in common with each other outside work. It is
essential that common goals, roles and responsibilities within the work team are
recognised. The workers should communicate effectively, despite lack of common
outside interests, for the benefit of individuals and the care team.

1.2 Different working relationships in a social care setting

It is important, not only to recognise what your own role is, but to understand the role
and responsibilities of others within the team. This will enable you to have realistic
expectations. Each individual team member will have specific responsibilities
associated with their job role and other responsibilities to the work team and its
members.

Individual team members and the complete care team

Recognising and respecting the rights and responsibilities of yourself and others, is
essential for healthy relationships, and will contribute to effective teamwork and
improve your knowledge and practice. When working independently you will follow you
job description as well as your company policies and procedures.
To fully explore your role within the care team it is important that you have a good
understanding of the job you are expected to carry out, the standards you must achieve
and who you are responsible to.

This staff structure below shows the complete care team. Senior Carers, Trained
Nurses and Managers are available to give ongoing advice, support and supervision
as part of their role and responsibilities. It is important that open lines of
communication are maintained to ensure the best care and interests of the individual.

The Manager

Trained Nurses

Senior Care Workers / Key Workers

Care Workers / Activities Organisers

If you work in a residential home, you will probably have no trained nurses. Likewise,
if you work in a nursing home you may have no senior care workers or key workers.
In individual’s homes you may be working alone frequently and have limited contact
with other team members. Contact with your manager or key worker will probably take
place outside individual’s homes.
Even within the smallest organisations, smaller teams operate within the complete work
team. This is because unlike other organisations care settings are likely to require
twenty-four-hour cover, seven days a week. The complete work team will then be
separated into smaller teams, working shifts to cover all the hours required. You will
probably work within one of these smaller teams. The staff you work with may vary a
great deal, day by day as shift patterns vary. Alternatively, you and your other team
members may work set shift patterns resulting in working with the same staff regularly.
The number of staff may vary between shift patterns as care needs vary throughout the
day.

Role of others within the care team

It is important that you can understand the role of others within the work team. This will
create better communication and reduce the risk of conflict. Teams who understand
and respect each other’s role will work together to provide a high-quality service for
the service user.
Managers/Matrons/Nurses have a role which involves being accountable for their
actions. They will carry out tasks, such as administering medications, which are
governed by a specific legal framework, and for which they will have been trained.
Planning and delivering care and co-ordinating the team to ensure each member
delivers the best quality of care is the Manager/Matron’s responsibility.

Work teams

When teams work well together, this has a positive impact on both individuals and
other staff. Having the right attitude at work is an expectancy of all staff.
There are many instances where individuals have to work as a team. Within a team, it
is ideal to have people from different backgrounds and experiences; this can help the
team to evaluate individuals’ needs, using ideas from a diverse group of individuals.

Teamwork

Your colleagues should be important to you. They should help you and you should
help them. Each member of staff will be good at different things. As you get more
experienced your skills will grow. Use them to help others.

Advantages of working in a team

• Giving and receiving help, guidance, and advice

• Sharing ideas, experience, and expertise
• Preventing breakdown of communication
• Reaching agreed goals i.e., providing best quality holistic care for clients.

It is vital that relationships between team members and individuals remain good. This
will create a pleasant atmosphere in which to work and live.

Advantages of good working relationships

• Improved communication
• Job satisfaction
• Improved co-operation and exchange of ideas.

People are more likely to share ideas and make suggestions if they feel they are being
listened to. This will result in team members and individuals feeling valued and
increasing in self-confidence. The care individuals receive will benefit greatly from a
well-motivated satisfied work team.

Recognising the teams that support the work you do

There will be several teams that support the work you do.
Your list may include:

• Domestic staff
• Catering staff
• Maintenance staff
• Laundry workers
• Administrators
• Other Agencies (Social Workers, Private Care providers)
• The Primary Care Team (Community Nurses, Doctors and other professionals)
• Hospital Doctors and Specialists
• Specialist Nurses
• Charitable Organisations
• Volunteers

It is important to recognise the individual roles and responsibilities within the team to
help and support each other.

Learning Outcome 2
The learner will:
Understand the importance of working in ways that are agreed with the employer.
The learner can:
2.1 Describe why it is important to adhere to the agreed scope of the job role.
2.2 Outline what is meant by agreed ways of working.
2.3 Explain the importance of full and up to date details of agreed ways of working

2.1 The importance of adhering to the agreed scope of the job role

It is important to adhere to the agreed scope of the job role to ensure that you only
undertake care practices for which you are trained, and your care organisation
supports you to carry out.

Standard 6 from The Skills for Care Code of Conduct states that adult social care
workers must:

“Strive to improve the quality of healthcare, care and support through continuing
professional development”.

Working outside of the scope of the job role could mean you are carrying out
procedures and practices that are outside your knowledge, expertise, organisational
policies, and national standards. This may result in poor practice, omissions, and
errors. Inevitably, the result of poor practice will be the suffering of the individual, your
work team and yourself.

Understanding the job role

To adhere to the agreed scope of the job role it is essential you understand the
specifics of the job description associated with the job role.
A role is a collection of related activities that is undertaken by an individual. It is
accompanied by an organised set of expected behaviours.
Roles in health and social care are shaped by organisation requirements and users’
needs and expectations, and it is these that are used to create a specific job
description.
To fully explore your role within the care team it is essential that you have a good
understanding of the job you are expected to carry out, the standards you must achieve
and what you are responsible for and who you are accountable to.

Your job description

Your job description should describe all aspects of your job role, in detail.
It is essential that you are clear about exactly what is expected of you and know when
your responsibilities begin and end. You may identify areas within your job description
that concern you, or you feel you need support with. If this is the case, it is imperative
that you report this and discuss your concerns with your manager. Alternatively, you
may wish to discuss aspects of your role, or responsibilities you develop over time,
which do not appear in your job description.
Failure to adhere to the scope of the job role can cause stress and conflict and may
lead to legal and disciplinary action.

Work priorities

It is important that workers learn to prioritise their work and that you support colleagues
in this. However, at times this can cause stress, especially during busy periods.
Support, guidance, and practical assistance must be provided by yourself and other
colleagues. Overburdening individuals with work they cannot complete, or work-
related stress they cannot cope with, may result in distress, and affect practice. It is
important to speak to a senior member of staff if you are struggling to complete your
duties within the time allocated. Your line manager may be able to offer you additional
support and resources.

2.2 Agreed ways of working

Policies and procedures

Agreed ways of working include policies and procedures where these exist. They may
be less formally documented with micro-employers (small organisations who have few
employees)

The policies and procedures of your organisation

All care organisations will have a range of policies and procedures.

Policies and procedures are intended to let everyone know the correct way to do
things. These are the organisation’s statement, or philosophy, about specific subjects,
relating to its business.
Some policies will have to consider UK Government legislation, whilst others may just
be a “Mission or Philosophy” that the organisation wishes to achieve.
The care sector is governed by several Acts and Standards and there should be a
copy of all of these, held by the care organisation.
Policies and procedures may include:
• Disciplinary policy
• Sickness/absence policy
• Moving and handling policy
• Safeguarding vulnerable adults’ policy
• Equal opportunities policy
• Health and safety policy
• Infection control policy
• Personal standards, hygiene and appearance/uniform policy
• Whistle blowing policy.
• Complaint’s policy
• Code of Practice for Social Care Workers
• Care planning and documentation policy

This list is not exhaustive, and you may be able to identify others.
Your care organisation should ensure that you are able, and know how, to access
policy content and are provided with written, relevant information where necessary.
Remember, you can only adhere to agreed ways of working if you are aware of and
understand the policies and procedures related to the work you do.
The care organisation should also ensure that agreed ways of working are
communicated effectively within the work team. This may be via the spoken or written
word, in meetings, handovers, training sessions and day to day working.

2.3 The importance of full and up to date agreed ways of working

Full and up to date agreed ways of working are essential to maintain a high standard
of service for the individual to promote the rights of the individual and the staff and to
enable the care establishment to function efficiently.
It is important that information about agreed ways of working contained in policies and
procedures and verbal communication are complete and up to date. Incomplete
information could result in health care workers not being fully informed of procedures
which may result in errors, omissions, and poor practice. If agreed ways of working are
not updated, in line with local and national standards and legislation, the care given
could include practices that are no longer considered safe or exclude new and
improved working practice. The result will be to the detriment of the individuals, the
work team and the care worker themselves, and may result in disciplinary and/or legal
action.
It is the care workers responsibility to ensure their knowledge and practice is up to
date. This is supported by The Skills for Care Code of Conduct. It states that as an
adult social care worker you must:
6.1 ensure up to date compliance with all statutory and mandatory training, in
agreement with your supervisor”.

Learning outcome 3

The learner will:

Understand the importance of working in partnership with others.
The learner can:

3.1 Explain why it is important to work in partnership with others.

3.2 Identify ways of working that can help improve partnership working.
3.3 Identify skills and approaches needed for resolving conflicts.
3.4 Explain how and when to access support and advice about:
‒ Partnership working
‒ Resolving conflict

3.1 The importance of working in partnership with others

It is important that individuals are able to feel successful in their daily lives.
Empowering individuals, encouraging self-management, and allowing them to become
partners in care will ensure that goals set are realistic.

The individual can then achieve their full potential. This will lead to a sense of fulfilment.

Partnership

It is important that you, as a care worker, build a trusting relationship. Always treat the
individuals and their home, (or room, if they are in a care organisation), with respect and
resist the urge to ‘take over’. Ensure that their rights and choices are upheld, always
maintaining a pleasant and willing attitude. This will prevent the individual from feeling
they are a burden.
It is also important to understand the value of working in partnership with individuals
and those significant to them (significant other’ means anyone who is significant to the
individual(s) you are supporting). Others may include:
• Unpaid carers (refers to those who provide unpaid support to relatives, friends,
or partners.)
• Family members
• Friends
• Advocates
Working in partnership with, and supporting others significant to the individual, will
benefit the individual and other in several ways:
 • Encourages ongoing support.
• Values the individual.
• Promotes good relationships.
• Improves quality of care.
• Promotes rights.
• Promotes a consistent approach to care and support.

Relationships with other within and outside the care environment

It is important to involve, encourage and support others significant to the individual,

particularly friends who offer a supportive social relationship to that of the family.
Contact with friends may reduce causing the individual to feel abandoned. Friends may
feel isolated or that they are “in the way” as family focus on meeting the individual’s
care needs.
The care worker can, with the individual’s consent, encourage families and friends to
visit and support then to communicate and understand the person’s needs, whilst, of
course, maintaining confidentiality.
The importance of contact with friends and family will apply whether the individual is
in their own home or a resident in a care home.
You, as a care worker, can encourage friendships between individuals receiving care
services by supporting communication and providing opportunities for socialising.
By working in partnership with others significant to the individual and supporting the
developments of relationships with others who have the potential to become significant
other will ensure the needs of the individual are met and the quality of their life
improved.

3.2 Ways to improve partnership working

It is vital that any team that operates within your care organisation works effectively.
This can only be achieved if each team member understands and fulfils their role and
responsibilities. Only then can a teamwork in harmony to fully meet the needs of the
individuals they care for.

Communication is the key

The only way to improve partnership working is to build relationships with people by
communicating effectively with them. Some care workers are naturally better than
others at this – but it is a skill that all care workers need to learn, which improves with
practice. However, you can learn from watching how others talk/communicate with
people.
It is important that all members of the work team learn to listen to each other, the
individuals they care for and those significant to them. Views and opinions should be
respected, and expertise and knowledge used to improve partnership working and
provide the best quality care. Any problems, communication difficulties and
misunderstandings should be acknowledged and discussed openly and calmly, and
resolutions agreed.

Reporting recording and information sharing

The most important aspect of good quality care is effective communication. Although
verbal communication is important, it cannot be relied upon, as information may be
forgotten or misunderstood. Written information is a permanent, unchanging record
that can be read several times to aid understanding. All records should be stored
securely and shared on a ‘need to know’ basis.

3.3 Skills and approaches needed for resolving conflict

It must be recognised that living together, especially with strangers as many individuals
in a care setting do, can create tensions within and between individuals. Tensions can
also exist between individuals, their care workers, and others. You can help individuals
to relieve tensions by:
• Developing trusting relationships
• Always ensuring that needs are met promptly and in full.
• Listening
• Ensuring that communication is open and honest.
• Maintaining a pleasant attitude

You can assist your individuals to resolve tensions

between themselves and others by:
• Identifying what the causes are
• Listening to both parties
• Helping both parties to reach a mutual
agreement to resolve the situation.

Resolving conflict:
• Talk openly and honestly about disagreements. Identify the causes.
• Explain to the person concerned how you feel.
• Be prepared to listen to the opinions of others.
• Be tolerant.
• Support others suffering from stress.
• Avoid misunderstandings by communicating clearly.
• Behave in a manner which shows respect for others.
• Adopt a pleasant and co-operative attitude.

Recognise your role and responsibilities, and how this relates to the role of
others within the team
Each member of the team should be aware of their responsibility to work in harmony
with individuals and colleagues and remain within their job role. Learning about the
culture, beliefs and behaviour of others will help everyone to develop a positive and
tolerant attitude. Good, open and honest communication is vital to ensure the team
functions effectively including good, clear, accurate records. Maintaining and updating
policies and procedures.
Management/the care organisation also have a responsibility to support staff,
individuals, and others by:
• Showing patience and understanding
• Ensuring effective management of staff by promoting staff well-being.
• Ensuring continued staff training and education.

3.4 How and when to access support and advice about partnership working
and resolving conflict

Partnership working

Cooperating and communicating with team members, individuals and others is an

essential part of each member of the team’s role. Your manner and attitude should
be pleasant and polite. All members of the team should treat each other, individuals
and those significant to them, with respect and tolerance, making every effort to ‘get
along’.

However, there are situations that may occur that will cause problems with partnership
working, including:

• Care workers being unable to understand their role or that of others.

• Inadequate Policies and Procedures
• Insufficient records and record keeping
• Low pay, long hours, shift patterns, illness, and lack of adequate staffing
• Poor and inadequate training/education/support
• Poor communication which may lead to a breakdown in relationships.

These are situations which are likely to be beyond the scope of your job role and may,
indeed, be affecting you directly. It is, therefore, the responsibility of the care
organisation to resolve those situations which adversely impact on effective
partnership working. Situations which cannot be resolved by communication within the
team and/or are beyond the scope of your job role should be reported to the manager.
It is their responsibility to ensure these situations are addressed to enable effective
partnership working.

Accessing support and advice about resolving conflict

Conflict can quite often be resolved by each party listening to each other,
understanding their position, and reaching an amicable agreement. Other situations
can be resolved by both parties agreeing to respect the others differing opinion and to
not let this affect their relationship.
Occasionally, there will be situations and circumstances where conflict cannot be
easily resolved. Situations become a problem when conflict:
 • Affects the development and maintenance of relationships.
• Hinders communication.
• Is potentially or adversely affecting standards of care.
• Creates a difficult working and living environment.
• Affects the emotional well-being of workers, individuals, and others.
• Is putting individuals, care workers and others at risk.
• Shows signs of escalating.
• Involves/leads to discrimination and/or loss of rights and choices.
• Affects team and partnership working.

Sources of support of advice

Sources of support and advice could come from colleagues, your supervisor/manager,
and external agencies such as Social Services, Care Quality Commission (CQC),
Carers Organisation and Unions. If you encounter problems, you are finding difficult
to resolve seek advice from your manager. Bullying, discrimination, or any form of
abuse must be reported immediately.

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now complete and upload the activities, workplace tasks and reflective
journal from before proceeding onto the next unit.
Unit 7 Understand Person-Centred Approaches in Adult Social
Care Settings J/602/3180

Unit purpose and aims

This Unit introduces the concept of person-centred support as a fundamental principle

of social care. This Unit is aimed at those who are interested in, or new to, working in
social care setting with adults.

Learning outcome 1
The Learner will:
Understand person-centred approaches for care and support.
The learner can:
1.1 Define person-centred values.
1.2 Explain why it is important to work in a way that embeds person-centred values.

1.1 Define person-centred values

A person-centred approach puts the person, not their illness or condition at the centre.
The needs and feelings of each person are the focal point around which everything
revolves.
Person-centred care is a care approach which aims to help you and other care workers
to see, value and treat people as individuals who have led, and are still leading their
own unique life.

Holistic/Whole care

It is now recognised that a person has needs beyond their physical care, therefore it
is important that the whole care needs of the person are met. Care should be planned
to take into consideration the religious, spiritual, psychological, social and cultural as
well as physical needs. This means looking at individuals as a whole person rather
than just focusing on their medical condition.
It is easy to forget that people are all different. None of us are the same – we all have
had different experiences of life as we have grown, we all have different personalities,
likes and dislikes.

Every one of us deals with events in our life differently.

Consequently, as a care worker, it will help to think about the person first, i.e., their life
history and what they enjoy. If as a care worker you can see the person, then this will
help you to consider how you can care for the individual.
Maintaining individuality and respect

• It is the right of each person to be treated as an individual. This will make them
feel valued and respected. You, as a care worker, can achieve this by the way
you treat individuals.
• Always find out the name they prefer to be called. Do not assume everybody
prefers first name terms, or endearments such as ‘dear’ (this may be seen as
belittling to the individual)
• Talk with and listen to individuals, key people and others to assess, needs,
wishes and preferences.
• Find out about the individual’s daily routine, their family and friends, hobbies
and interests.
• Plan care holistically
• Be polite, helpful and show empathy.
• Ensure individuals have contact with family and friends.
• Encourage personal items, e.g., photographs, furnishings, ornaments etc
• Do not clothe clients in items that belong to the care establishments.
• Encourage the wearing of day clothes.
• Give choices, uphold rights.

Rights

A right is something you are entitled to receive. Rights and choices are a vital part of
good practice. You, as a care worker, should be aware of individual’s rights and
choices and ensure these are fostered, supported and promoted at all times.

The Human Rights Act 1998

Everyone in the UK is entitled to the same rights and freedoms. These include:

• The right to life

• The right not to be tortured, also not to be punished in a degrading or inhumane
way.
• The right not to have to do forced labour.
• The right liberty and security of person
• The right to a fair trial
• The right to freedom from retrospective penalties or laws
• The right to respect for family life, home and correspondence.
• The right to freedom of thought, conscience or religion
• The right to freedom of expression
• The right to freedom of assembly and association
• The right to marry and have a family.

The Mental Capacity Act 2005

This provides a framework to protect vulnerable adults who are unable to make their
own decisions about the care and support they require. The key points are:
• Capacity is presumed unless proven otherwise.
 • All available help and support given to enable individuals to make decisions
before reaching a conclusion that they lack the capacity to do so.
• An individual retains the right to make unhealthy choices and decisions if they
so wish.
• Any intervention must be in the individuals’ best interests and not infringe basic
rights.

The Mental Health Act 2007

This provides a new revised framework which is more applicable to the current support
and services that are available.

The Mental Health Act 1983 – identifies measures to uphold rights for those with
mental health problems.
Care Act 2014

This promotes person-centred approaches and supports individuals’ rights to make

informed decisions about their care and support.
The Skills for Care Code of Conduct states that adult social care workers must.
2.1 always act in the best interests of people who use health and care services.
2.3 put the needs, goals and aspirations of people who use health and care services
first, helping them to be in control and to choose the healthcare, care and support they
receive.
Other legislation and policies that would relate to promoting rights and responsibilities:
• Use of restraint
• Taking risks
• Preventing / managing violence
• Complaints procedures.

It is vital that individuals feel in control of their lives. Ensuring they are aware of their
rights and choices and that these are actively promoted will help individuals to be
confident and develop a feeling of self-worth. Individuals should be encouraged to say
what they want, express opinions, and make suggestions about the care they receive.

Assisting individuals to access their rights and responsibilities

You, as a care worker, have a duty of care to promote and protect the rights of
individuals. It is the responsibility of all the care team to ensure that individuals obtain
their rights and are aware of their responsibilities and choices.
Monitoring, recording and reporting of any problems with accessing rights is essential
to ensure individuals’ rights are upheld.
The right to choose

We all expect that we have a right to choose. Being cared for does not alter this right.
An individual does not lose all ability to do things for themselves or make choices, just
because they become ‘a client/patient/service user’. It is important to maintain
individual’s chosen daily activities, maintain their physical activities and keep the body
exercised.
• Mentally – it keeps the mind alert.
• Emotionally – it provides stimulation, interest, a sense of self-esteem and
individuality.
• Socially – it keeps contact with others and maintains social skills and identity.

Achievement and fulfilment

It is important that individuals are able to feel successful in their daily lives.
Empowering people, encouraging self-management, and allowing them to become
partners in care will ensure goals set are realistic. The individual can then achieve
their full potential. This will lead to a sense of fulfilment.

Active support

You must provide active support to enable individuals to use their strengths and
potential. This means setting realistic goals and giving positive feedback and
encouraging (but not forcing) self-management.
Individuals must be supported to identify how they want you to carry out your work
activities. This upholds their right to choose and will encourage and empower the
client.

Privacy and dignity

The Human Rights Act states that a person has a right to privacy, dignity, and respect.
Privacy may be viewed as privacy of information, the provision of private areas for
individuals and privacy that involves covering the body.
All individuals have the right to be provided with a private area to wash, dress, attend
to toilet needs, meet with visitors, receive treatment, relax or be alone.
Clothing should be of the individual’s choice and should cover the body adequately to
maintain dignity. Individuals should also be offered advice and support to choose
clothing appropriate for their personal needs and the activities they are undertaking.
An abrupt, impatient or intolerant attitude will humiliate and dehumanise the individual
and should be considered abusive. Care settings where care practices are
institutionalised, do not maintain dignity, privacy or show respect.
Independence, freedom and being in control

The care plan should focus on the individuals’ strengths, abilities and wishes. You
need to promote independence and help individuals to feel in control of their lives and
to feel confident. Individuals should have the freedom to make their own choices and
to live the way they want to.

1.2 Why it is important to work in a way that embeds person centred values

Partnership and participation

Individuals should be included in the planning and delivery of all aspects of their care.
This will ensure that the service provided puts the individual at the centre of everything
you do. Decisions are made and care is delivered with the individual’s knowledge,
understanding, co-operation and consent. You, as a care worker, should actively
support individuals to participate as much as they are able.
Your aim as a person-centred care worker is to make sure that each day is as positive
as it can be for each person.
Care workers can show respect and preserve dignity by always supporting individuals’
choices and upholding their rights.
People entering a care home or receiving care in their own home may experience
several losses, particularly a loss of independence. There is a danger that loss of
independence will lead to loss of identity, which may be a direct result of people who
need care being treated in the same way. This is particularly so in care settings or
organisations whose routines fit more closely with the needs of the organisation than
that of the individual.
As a care worker you can help an individual hold onto their senses of ‘who they are’
by respecting their individuality, getting to know them, and learning their life history.
Understanding the uniqueness of the person will promote Individuality. If we look
closely at the person’s individuality recognising their strengths and skills to promote
independence.
Privacy is not only ensuring private areas for personal care but also the individual’s
private and confidential information. There may be other ways of promoting the
privacy dignity of the individual, the most important aspect for you to learn is you should
always treat the individual with the respect you would expect for yourself or a member
of your family, listen to what individuals have to say and encourage and accommodate
their choices and personal preferences. It is vital that you ensure the individuals’
comfort is ensured, the care team should be aware of their needs and should strive to
meet these by providing the best possible quality service creating a relaxing and
harmonious atmosphere is as important as having pleasant and comfortable physical
surroundings.
Learning outcome 2
The learner will:
Understand how to implement a person-centred approach in an adult care setting.
The learner can:

2.1 Describe how to find the history, preferences, wishes and needs of the individual
2.2 Describe how to take into account the history, preferences, wishes and needs of
an individual when planning care and support.
2.3 Explain how using an individual’s care plan contributes to working in a person-
centred way

2.1 How to find out the life history, preferences, wishes and needs of an
individual

The meaning of life history work

This is the process of finding out who a person really is. It is not just about compiling
a list of what the person has done where they lived etc.
Each of us is formed by our past life. We all have a life history. It is made up of the
things which have happened to us in our lives and the way they have affected or been
affected by our own personality. Our own story of our life is part of the story of our
family; that is our identity.

Ways to collect life history information

A profile may include an individual’s:
• Likes and dislikes. • Disappointment and achievements
• Values and beliefs • Routines and habits
• Life experiences, events and • Talents, hobbies and interests
encounters • Work life and education.
• Significant people, places and
objects

The obvious place to start, and one which is often overlooked, is to talk to the person
themselves about their life. Many care workers have a lot of information about
individual people but the only place it is recorded is in their heads. This means that
when they are off duty the information is not available for other staff to use to help the
person. All information should be recorded following the obtaining of information by
talking to and listening to the individual. To achieve this:
• Avoid any distractions, interruptions such as telephones, television, passers-by
etc.
• Give the individual your full attention, concentrate on what the individual is
saying - not what you are going to have for lunch.
 • Look interested in what the individual has to say, even though you think that
what the individual is telling you is unnecessary and boring remember that all
information is relevant.
• Stay directed and focus on the individuals’ feelings.
• Allow the individual to complete what they are saying and avoid interrupting the
individual whilst he/she is talking.
• Try to use positive non-verbal cues to encourage the individual for example
maintaining eye contact, facial expressions and touch, and be aware of your
facial expressions and body language.
• Ensure that you do not pretend to understand what the person is saying, if need
be, ask questions to help understanding
• Ensure that any feedback you give is clear and unambiguous.
• Give minimal prompts to acknowledge that you are listening and that you are
interested, for example, nodding or shaking your head or simply saying ‘yes’.
• Be well timed and vary your responses ensure that you reflect back to the
individual during brief interactions, for example “If I understand correctly, you
feel that…”
• Try not to put your own feelings, ideas, and opinions on to the individual and
hold back the need to respond with advice or an opinion unless asked to.
• Be aware that the person's feelings and perspectives may not be the same as
yours
• Listen to the person to understand them rather than to achieve an agreement.

A life history is not something which is completed in one session on one day.
Information comes gradually from several different sources. Personal care sessions
when you are alone with the person will often be the time and place where people’s
stories are told about their life. It is important to record these.
Friends and family are another rich source of information about the person. Some
families will want to pass on as much information as they can and may find that writing
a mini biography about their relative helps them over the period when the decision is
made to move the person into a care home. Others will not. There will be many
reasons for this. Care staff must work with what life history information is available.
Family photographs are a useful source of life story material and can be used to make
life storybooks. Involving the family and the individual in this is often a pleasant activity
in which they may all enjoy. It is important that the names of significant people in
someone’s life are known, you need to know if this is her/his husband/wife, his/her
brother, his/her son/daughter, his/her lover, or his/her dog!
Many people in care homes have had long associations with community groups such
as churches, service associations, trade unions, professional bodies. Everyone has
lived in a street, a neighbourhood, a town, or village. Local information can be
especially useful in collecting life history. This provides cues which help the care
worker to meet the preferences, wishes and needs of an individual when planning care
and support.
It is important for you and other care workers to share all information you collect, on a
need-to-know basis to ensure that you are working as team and promoting good quality
care for the individual.

Other external members of the team could include the GP, the District Nurse and
Social Worker may also be included as a source of history or information.
All information gathered from whatever source should be recorded and used for
reference and referral for those involved in the care of the individual.

2.2 How to take into account the history, preferences, wishes and needs of the
individual when planning care and support
When planning care that is holistic and person centred the care worker must consider
the individual’s life history to meet their preferences and wishes. For instance, if the
individual has spent several years visiting the grave of a loved one on a Sunday, to
tend the site and to replace old flowers, having knowledge of this means that
appropriate arrangements could be made to ensure that this important area of the
individual’s life continues and is supported. Alternatively, to ensure the individual’s
preferences are considered such as their choice of soap brand, toothpaste, food
preferences, newspaper, music, TV programmes would ensure a person-centred
approach to care.
The individual’s rights, including the right to choose must be upheld. Incorporating their
life history can identify their preferences. These may include choosing:
• Diet and fluids
• When to have visitors
• Recreational activities
• How the care setting is organised and the
care they receive
• Hygiene facilities and standards
• To care for themselves
• To communicate using their preferred method
and language

The benefits of life history work to the individual concerned

The individual will perceive that care workers are taking an interest in them and value
them as an individual. Involving the person in life history work can be very fulfilling and
prove therapeutic for the individual concerned. People derive enjoyment from the
relationships formed with care staff who know them well and can use their knowledge
of the individual to plan care which is truly person centred.

2.3 How using an individual’s care plan contributes to working in a person-

centred way
An individual’s care plan is an important source of information where day to day
requirements and preferences for care and support are detailed. This document gives
personal information about all aspects of care for the individual which would include
their cultural and religious preferences these could possibly influence what the
individual likes to eat and drink, how their personal care is completed, do they prefer
a bath or shower, how often they like to bath or shower, what their preferences with
toiletries. How often they like to visit the hairdresser/barber. Care plans should also
document the individual’s history such as their occupation, hobbies, interests,
achievements. It may also include future wishes such as goals or desires. This helps
the care team to have a clearer understanding of who the person is.
The individual themselves should be involved in, and have knowledge of, the care plan
and be able to understand and access the contents in order that they are able to fully
participate in their care and contribute towards decision making.
All care professionals should read the care plan to inform their practice and enable
them to care for the individual in a holistic, person-centred way. It is also essential that
entries made into the care plan reflect the person’s needs wishes and preferences.
The care plan should be reviewed at least monthly and when there are any changes
in the needs of the individual to ensure that the care planned continues to meet their
needs. Any changes made to the plan of care must continue to place the individual at
the centre of all the care team do and must be understood and agreed by the individual.

Making records

It is essential that you record what you have done, outcomes of communications and
any problems you have encountered. This should be within confidentiality agreements
and according to legal and organisational requirements.

Learning outcome 3
The learner will:
Understand the importance of establishing consent when providing care or support.

The learner can:

3.1 Define the term “consent”.
3.2 Explain the importance of gaining consent when providing care or support.
3.3 Describe how to establish consent for an activity or action.
3.4 Explain what steps to take if consent cannot be readily established.

3.1 Defining the term consent

Consent can be defined as “informed agreement to an action or decision”; the process
of consent will vary according to an individual’s assessed capacity to consent. Consent
may be implied, written of verbal.

3.3 The importance of gaining consent when providing care or support

Individuals can only give consent to treatment if they understand the reasons, the
benefits, and any possible disadvantages of the care planned. By withholding
information about their treatment means you are withholding their rights and therefore
they are unable to give their informed consent to care planned for them or be involved
in the care planning process.
To identify and meet the needs and preferences of the individual, it is important to have
as much relevant information and advice as possible, available through
communication and assessment of the individual. Consent should never be
considered a ‘one-off’ event.

3.4 Describe how to establish consent for an activity or action

It is important that, as a care worker, you establish that an individual consents to care
and support you and others provide and you know how to do this. This is called
informed consent and it is their legal right.

The consent of the individual is established regarding the sharing of confidential

information, within a care setting, between care professionals who have the right and
need to know. Continued sharing of this information between care professionals is
called implied consent, as it is assumed that the individual wishes the care team to
continue to share information unless the individual states otherwise. This is justified by
the need to share information that will benefit the individual’s health and well-being and
ensure their care needs are fully met.

Consent can be obtained verbally. This involves clearly explaining to an individual the
reasons for a particular aspect of care and support, establishing their understanding
and receiving their consent verbally. This can be via the spoken word, sign language
or using technology. Establishing consent using the spoken word requires the care
worker to ask the appropriate question at the appropriate time for example: “would you
like a bath?”, “shall I run you a bath now?” or “what time would you like your bath?”,
which requires the appropriate answer indicating consent to the activity. If the
individual needs to communicate using sign language, then the same questions could
be asked using sign language or cue cards. Care workers should ensure that hearing
aids or worn, switched on and in good working order prior to asking questions and
gaining consent.

In addition, you should explain the use and purpose of the care activity and any related
equipment, to the individual, establish their understanding and ask them directly if they
wish to proceed. This will give them an opportunity to ask questions and express
concerns or obtain information from other care professionals and to then decide
whether to consent. You should always record consent and how it was obtained in the
care plan.

Some individuals may be able to understand information verbally but are only able to
respond non-verbally in the form of gestures, facial expressions, and other body
language such as nodding. It is particularly important that you establish the way they
convey their consent and that this is recorded. For some people who are very disabled
or incapacitated, blinking their eyes may be their only means of communication,
therefore, correct interpretation of non-verbal communication is vital.
Written consent

Consent may be also obtained in writing. This is less common in general day to day
care and support, but is used to obtain consent for surgical procedures, certain
medications, investigations, and treatments. In this case the individual must be
provided with written information which must be supported by clear and
understandable verbal information.

Written consent forms are often used with self-administration of medication following an
assessment of the individual’s abilities. This consent would be reviewed on a regular
basis or as the need arises or where agreed compliance fails.
Advice must be taken from management who will act on guidance contained in
legislation and organisational policies and procedures.

3.4 The steps to take if consent cannot be readily established

In certain care settings and with certain individuals, obtaining consent may be more
difficult. This may be because a person has no speech, a lack of insight into their
communication needs, such as people with dementia or those who are unable to
communicate due to an unconscious state. You will need to seek advice and support
to meet the individual’s needs.

Communication Problems
There may be occasions where you have problems understanding an individual’s
communication, or they may have problems understanding you. It is vital that you
seek appropriate support and guidance to resolve this. You must never feel that you
should be able to communicate with and understand all individuals, and that if you
cannot you have failed. All people will, at times, have difficulty communicating with
others or making themselves understood, even if there is no obvious physical or
psychological barrier to communication. If you feel that consent has not been given or
established then do not continue with the task at this point instead try to establish why
the individual has not given consent, you could return later and try again or ask a
colleague to try to gain consent, if all fails report and record your actions to your
manager.
Not seeking support when these situations occur may result in the individual’s care
needs not being met and information, they require enabling them to give informed
consent not being communicated to them.

Matching Communication to the person

It is important that you and your colleagues change and
adapt the way you communicate with each person, so you
are considering their:
• Individuality
• Life history
• Culture
• Unique strengths
 • Experience of a dementia or/mental health
issue/learning disability, where applicable
• Feelings

An important skill in communication is to display genuineness and that you are ‘there’
for the person.

Advocacy

This is a process which enables those unable to fully exercise their rights, to have their
rights upheld. This is achieved by representation from a third party. The advocate
may be informal or appointed by the court. When you identify individuals, who may
be unable to exercise their rights, you may be in a position to speak on their behalf.
In certain circumstances this may not be possible, as it may be beyond your role and
responsibilities. You must then ensure that you discuss issues with your manager, who
will be able to arrange advocacy services.
It may be possible to enlist the support of an independent advocate to represent the
interests of the individual. If there is conflict of interests between the individual and
the care team, an advocate can make them feel they are being listened to and have
someone on their side. This may have the effect of taking the pressure off the
individual and easing the tensions that exist between them and the care team. This
may result in the lines of communication remaining open so that a solution, agreeable
to all parties, can be reached.

Sharing information

Whilst you may fully understand the concept of confidentiality, deciding whether to
share the information that you receive with others, especially when it is of a serious
nature, can be a difficult decision to make.
Confidential information can be disclosed to an appropriate health care professional if
it is relevant to the care of that individual. It is justified on the basis that the individual
may suffer if that information is withheld, e.g., not passing on the fact that an individual
has an understanding difficulty may result in their needs not being identified.
Individuals giving information in confidence, have a right to expect that it will only be
used for the purpose for which it was given, and that it will not be shared with others
without their consent. Care staff are not released from this responsibility, even when
the person dies.
Sharing information with family and friends of the individual must be done with consent.
If the individual lacks capacity to give consent for their information to be shared, then
the Mental Capacity Act should be followed. This ensures that sharing information
about the individual is in their best interest. Any decisions or reasonings should be
recorded.
Lack of mental capacity and consent

Certain individuals may lack capacity to make decisions and therefore are unable to
give informed consent. It is important that you are aware of, and understand, the
legislation relating to mental capacity.

The Reasons for and Aims of the Mental Capacity Act 2005

The Mental Capacity Act 2005 provides a statutory framework which aims to empower
and protect vulnerable people who are not able to make their own decisions. It makes
it clear who can take decisions, in which situations, and how they should go about this.
It also enables people to plan for a time when they may lose capacity.

Definition of the Mental Capacity Act

‘Mental Capacity’ within the context of the Mental Capacity Act 2005 refers to
‘an individual’s ability to make a decision’. There are various differing factors which
can affect an individual’s ability to make a decision, including conditions such as a
stroke, dementia, learning disability and physical illness, head injury, drug or alcohol
intoxication, mental health problems, trauma, loss and bereavement. In addition,
conditions such as an intimidating or unfamiliar environment can also affect capacity.

Defining Lack of Mental Capacity

If Mental Capacity refers to an individual’s ability to make a decision, then we can

assume that there may be times when individuals may lack the capacity to make a
decision, and there are several factors that can influence this. Within the context of the
Mental Capacity Act 2005, a person is deemed to lack capacity if because of an
impairment of or a disturbance in the functioning of the mind or brain’ (Which may be
temporary or permanent) he/she cannot do one or more of the following four things:
1. Understand the information relevant to the decision.
2. Retain that information long enough to make the decision.
3. Weigh up the information available to make the decision.
4. Communicate their decision (whether by talking, using sign language or other
means).

Determining capacity

A person is unable to make a decision if they cannot understand information relevant

to the decision, retain the information, use or weigh the information to make the
decision, communicate the decision.

The Assessment Process

The Mental Capacity Act 2005 sets out the best practice approach to assessing
capacity. The steps taken to initially determine whether a person lacks capacity will
depend on the individual circumstances and the urgency of the decision required to be
made as the assessment of capacity should be specific to the decision needing to
be made at that time. The Code of Practice sets out quite clearly the details that are
involved in assessing an individual’s capacity to make decisions.

The Code of Practice identifies a two-stage process to the assessment of capacity and
identifies two questions that need to be asked.

Stage 1: Does the person have an impairment of, or a disturbance in the

functioning of their mind or brain?

If this is so, the assessment will move on to stage 2:

Stage 2: Does the impairment or disturbance means that the person is

unable to make a specific decision when they need to?

This two-stage assessment process must be followed, and the assessor must
be able to demonstrate that it has been followed.
Assessing and reviewing capacity is not just a one-off event. It is essential that capacity
is reviewed on a regular basis, as people can experience changes in their decision-
making capabilities. Capacity should always be reviewed whenever a care plan is
being developed or reviewed, at other relevant stages of the care planning process,
and as particular decisions need to be made.
Assessing capacity correctly is vitally important to everyone concerned with the Act,
and there are a few reasons for this.
• A person who is assessed as lacking capacity may be denied their right to make
a specific decision, this is particularly true if others think that the decision would
not be in their best interests or could cause harm.

• If a person does lack the capacity to make specific decisions, and this has not
been assessed, then that person may make a decision they do not really
understand. This could cause harm to the person or put the person or others at
risk

• The person who is responsible for undertaking the assessment is accountable

for his or her actions; and the person who does or does not undertake an
assessment at the appropriate time will be called to account for anything that
may happen because of their actions.

So, we can see it is essential that an assessment is carried out whenever there is
doubt about a person’s capacity. It is also vital that the person who does an
assessment can justify their conclusions.

Who should assess Capacity?

The best person to assess an individual’s capacity to make a decision will usually be
the person who is directly concerned with the individual at the time the decision needs
to be made. This means that there could be different people involved in assessing
someone’s capacity to make different decisions at different times.
Where more complex decisions need to be made, a specialist opinion on the person’s
capacity may be necessary, for example an assessment may be requested from a
psychiatrist, psychologist, a speech and language therapist, occupational therapist, or
social worker. But the final decision about a person’s capacity must be made by the
person intending to make the decision or carry out the action on behalf of the person
who lacks capacity and not the advising professional.

Any person, regardless of their professional status, who takes responsibility for
assessment, must have the skills and ability to communicate effectively with the
individual being assessed. If necessary, they must engage in professional help in order
that they can communicate effectively with the person.

Learning outcome 4

The learner will:

Understand how to encourage active participation.
The learner can:
4.1 Define what is meant by active participation.
4.2 Describe how active participation benefits an individual.
4.3 Describe ways of reducing barriers to active participation.
4.4 Describe ways of encouraging active participation.

4.1 The meaning of active participation

Active participation is a way of working that recognises an individual’s right to

participate in activities and relationships of everyday life as independently as possible:
the individual is regarded as an active partner in their own care or support, rather than
a passive recipient.

4.2 How active participation benefits an individual

Active participation is important to improve feelings of well-being and self-esteem.
They also provide an outlet for creativity and help to prevent boredom. Well planned
activities can also help to meet a person’s psychological needs.
Without us offering opportunities and helping people to be occupied they are likely to
feel the following things:
• Useless and worthless
• Not valued
• That nobody cares about them

This is a situation in which it is especially important to find out as much as possible

about the life history of a person in relation to their former work and the way they filled
their time. When we do this, an individual’s actions which appears to be bizarre and
meaningless turns out to make sense to us.
Care homes should provide opportunities for this type of occupation. This is relatively
easy for women and occasionally some men in the oldest age group, as they would
all have done housework – polishing, dusting, washing up, helping to make the beds,
sweeping, folding laundry, drying up – you will be able to think of a list of things which
count as occupation. The challenge is greater for most men, but it is still possible with
imagination to think of activities associated with former jobs – gardening, ‘repairing’
objects (e.g., clocks), washing the car, sorting papers, keeping an appointments diary,
making lists of words or numbers. It is extremely important to learn as much as you
can about the person’s life history to help create for them ways to be busy linked to
their past work life or housework.
Active participation benefits the individual by providing opportunity for:
• Variety and interest in people’s daily lives
• Stimulation of specific abilities.
• Enjoyment & fun
• Opportunities for creative self-expressing
• Opportunities to make choice.

4.3 Ways of reducing barriers to active participation

Some barriers to active participation are:
• An activity made too easy make the individual feel like a child.
• An activity that is too difficult can make a person feel inadequate.
• An activity that does not take into consideration the persons cultural needs and
preferences.
• An activity that is both costly in time and expense
• Not making use of the skills of other people
• Not assessing their current abilities
• Not completing an assessment on their knowledge and life history

It is important not to set people up to fail.

When considering active participation this should only be undertaken with a good
knowledge of the individual’s preferences, past life – including occupation, cultural
background, and current capabilities. The individual should be regularly assessed, and
updates included in their care plan.

4.4 Ways of encouraging active participation

Ways of encouraging active participation are:
• Gentle words of encouragement to highlight the benefits of the activity.
• Planning activities to suit the person’s capabilities strengths and abilities.
• Taking into consideration disability and adapting activity accordingly
• Addressing barriers to communication and adapting approaches
• Providing aids to promote inclusion.
• One-to-one assistance where needed.
 • Identifying personal likes and dislikes and
experiences and matching these with activities
the person will be interested in and enjoy.
• Using friend and family to encourage and
participate.
• Planning activities appropriate to the
person’s cultural and religious beliefs and
preferences
• Preparation of the environment, equipment
and aids used.
• Breaking tasks down into manageable steps

Learning outcome 5

The learner will:

Understand how to support an individual’s right to make choices.

The learner can:
5.1 Identify ways of supporting an individual to make informed choices.
5.2 Explain why risk-taking part of an individual’s choices can be.
5.3 Explain how agreed risk assessment processes are used to support the right to
make choices.
5.4 Explain why worker’s personal views should not influence and individual’s
choices.
5.5 Describe how to support an individual to question or challenge decisions
concerning them that are not made by others.

5.1 Ways of supporting an individual to make informed choices

Communicating effectively and developing a trusting relationship with individuals and
those significant to them is vital if you are to support individuals to make informed
choices.
To make choices it is important that an individual has clear, accurate and sufficient
information about the choice being offered. Also, that they fully understand the
implications of the choice they make, and the benefits, disadvantages and potential
risks related to the choices available. It is your role to make information available to
the individual by giving the information verbally in a clear understandable way. You
may also need to access resources, such as written materials, to reinforce verbal
information. Ensure you seek advice and guidance of other professionals to support
you and the individual. Always check the individuals understanding of the information
provided.
The individual should be reassured that their right to choose will be respected and they
will be supported in their choice. They should also be given time to consider the choices
available and encouraged to discuss matters with those significant to them. Ensure
you answer questions honestly; give clear explanation and offer reassurance.
Individuals must feel in control of their lives and being supported to make choices will
make them feel empowered.
Ensuring clients are aware of their rights and choices and that these are actively
promoted will help clients to be confident and develop a feeling of self-worth.

The right to choose

Choices may vary from choosing activities associated with daily living to major life
changing decisions. The care setting/organisation can support choice by encouraging
individuals to:
• Choose recreational activities.
• Choose diet and fluids.
• Have visitors.
• Have a say in how the care setting is organised and the care they receive.
• Choose hygiene facilities and standards.
• Choose to care themselves.
• Communicate using their preferred method and language.
• Choose a preferred place of care.

Individuals must be supported to identify how they want you to carry out your work
activities. This upholds their right to choose and will encourage and empower the
individual.
Individuals should be encouraged to say what they want, express opinions, and make
suggestions about the care they receive.
The nature of caring means, that at times, as a care worker, you are performing very
personal, intimate tasks. People must feel as comfortable as possible and it is
essential, they feel they have a trusting, therapeutic relationship with the care worker.

5.2 Why risk-taking can be part of an individual’s choice

Care organisations should ensure that all individuals’ rights and choices are respected
by giving the individual freedom to take risks. Every day we all take risks. This is
something we are entitled to do, as are the individuals we care for. Generally, we are
aware of the risks we take, and we have sufficient information to decide whether we
wish to continue with the activity that carries the risk.
However, as care workers we do have a duty of care and by carrying out risk
assessments we make the attempt to balance risk taking, rights and responsibilities.
We assess what the risk is and what measures can be implemented to try to reduce
the risk; there may be occasions however when it is not possible to reduce or eliminate
the risk and the individual must be able, and has the right, to make the final decision
regarding whether to take the risk. There are also occasions when, following
assessment, we as health care workers identify risks that individuals may not have
considered for themselves, for example, nutritional assessment or pressure ulcer
assessment. Our communication and explanation to individuals in these instances is
obviously of utmost importance.
If individuals are encouraged to take positive risks, it can increase their independence
and self-determination. It may prevent an individual from deteriorating and improve
their quality of life.

Balancing individual choice with risk

Balancing individual choice with risk is a difficult issue to deal with, as a person is
entitled to make their own choices in life and therefore their own risks. For example,
an individual with emphysema may decide to continue smoking despite knowing they
are accelerating the disease process. Even though the risk to the person’s health is
considerable care professionals must accept that the individual is entitled to make an
informed choice to take the risk, and that they have no power to stop the person taking
part in the activity. The only restriction the care organisation can impose on the
individual is where they can and cannot smoke. Individuals, who self-neglect or self-
abuse through choice, have a right to choose but have a responsibility to those around
them. They are not entitled to make choices that put others at risk. Social Services
and other agencies must become involved to protect all those involved. It is important
that you understand this, as you have a ‘duty of care’ to all your individuals and a
responsibility to others. You must report any concerns you have to your manager.
For those who self-neglect or self-abuse through vulnerability, it is important that health
care professionals become involved, if that risk becomes so great that the health,
safety and well-being of the individual and others, is put at risk.

5.3 How agreed risk assessment processes are used to support the right to
make choices

The policy and procedures of your organisation will clearly state what both the
employee and employer’s responsibilities are concerning risk. These will be in line
with legislation. It is important that you make sure that you are aware of these.

Work responsibilities will be influenced by organisational procedures which determine

each care worker’s role in the process of alerting and reporting risks.
Agreed risk assessment processes are important in supporting individual’s right to
make choices. The process of risk assessment enables the risk to be identified, the
level of risk and the probability of harm established. Once identified, the risk can be
discussed with the individual and control measures put in place. The individual can
then examine and discuss the risk assessment and control measures and make an
informed choice about taking a particular risk.
The individual may at times make, what care workers believe, are unwise decisions
which may adversely affect their health and well-being or the health and well-being of
others. This may be because they do not fully understand the implications of their
choice or, in some circumstances, may be making informed choices, despite fully
understanding the consequences or risks taken for example the use of pressure mats
situated near exits of the building alert staff to individuals exiting the premises whilst
allowing the individual to exercise control over their lives.
You need to be aware of your responsibilities towards the individuals and your
employer. There will be general definition of employees’ responsibilities, and certain
responsibilities expected of individual employees.
5.4 Why a worker’s personal views should not influence an individual’s choice
It is important that the workers views do not influence a person’s choices. It is as
previously discussed, the individual’s right to make choices. No two people are the
same and views, opinions and choices may differ significantly. However, these
differences must be accepted and respected.
An uneven balance of power exists between care worker and those they care for. The
care worker should never abuse this power by exerting pressure on an individual to
influence their choices. Individuals must not be pressured into making decisions they
are unhappy with, be denied activities they find enjoyable or be coerced into
participating in inappropriate or unsuitable activities.
The care worker should not express opinions about the care organisation which may
unduly influence the individual.

5.5 Describe how to support an individual to question or challenge decisions

concerning them that are made by others
Individuals must be supported to challenge decisions concerning them made by others
who may include:
• Care workers
• Social worker
• Occupational therapist
• GP
• Speech and language therapist
• Physiotherapist
• Pharmacist
• Nurse
• Specialist nurse
• Psychologist
• Psychiatrist
• Advocate
• Dementia care advisor
• Family or carers

Encourage individuals to speak with you, you may be able to discover what is worrying
them. Answer their questions and give information, explanations, and reassurance.
The main message the individual will want to hear is that they are in control of what
happens to them, and the care they receive is planned in partnership with them and
key people involved in their care such as Social Worker, GP, Pharmacist, and
specialist agencies. This will make the person feel empowered and they may be more
willing to accept the care they need. It is important that individuals can feel successful
in their daily lives. Empowering individuals, encouraging self-management, and
allowing them to become partners in care will ensure goals set are realistic. The
individual can then achieve their full potential. This will lead to a sense of fulfilment.

Assist to complain
• Encourage questions and comments.
• Be prepared to listen.
• Assist the individual to ask for a second opinion.
• Speak on behalf of the individual or refer the individual to a senior member of
staff.
• Use and follow the complaints procedure.

Complaint’s procedures
It is vitally important that individuals are not only provided with a Charter explaining
their rights and responsibilities, but that they are provided with information about how
to comment on care services and complain if they feel their rights are being withheld.
The complaints procedure may need to be adapted to meet the communication needs
of the individuals, for example providing a copy in audio format, picture format, large
print or Braille. Care workers should also be made aware of the complaint’s procedure,
to enable them to make a complaint themselves, if they feel this is necessary, or to
assist a person to complain.

Learning Outcome 6
The learner will:
Understand how to promote an individual’s well-being.
The learner can:
6.1 Explain how individual identity and self-esteem are linked with well-being.
6.2 Describe attitudes and approaches that are likely to promote an individual’s well-
being.
6.3 Identify ways to contribute to an environment that promotes well-being.

6.1 How individual identity and self-esteem are linked with well-being
Your identity is personal to you and it involves several different aspects that are unique.
Your self-esteem is how you think and feel about yourself. Well-being is what we all
need to make life worth living and it is dependent on our identity and self-esteem. In order
to maintain well-being, we need to recognise whole care needs, know the individual’s
life history, ensure our approach is person-centred and focuses on treating a person as
an individual whilst preserving their identity and maintaining self-esteem. The person
who is experiencing well-being will:
• Be able to communicate with others.
• Express their wishes
• Form meaningful relationships.
• Show pleasure and enjoyment.
• Have a strong sense of self/personal identity.
 • Have a sense of purpose.
• Show signs of self-respect.
Being valued and respected as an individual with a distinct identity will promote feelings
of self-worth and maintain self-esteem. This will result in the preservation and
maintenance and well-being.

6.2 Describe attitudes and approaches that are likely to promote an

individual’s well-being
Care plans should be developed in partnership with the individual and a person-
centred approach used to meet the individual’s whole care needs, wishes and
preferences. These may include:
• Physical care that is personal and offers individual choice.
• Emotional care that is sensitive to our feelings, individuality and past life
• Social care that is relevant to how we spend our time in an individually
meaningful way.
• Spiritual care that is respectful of the meaning to our lives
• Cultural care that respects our identity
• Religious care that respects our beliefs
• Care that promotes mental health
• Sexual care which recognises our sexuality in a sensitive and respectful way
• Political care which is sensitive to our views and opinions
It is important to promote the wide range of medical and social approaches that can
help maintain a person’s self-esteem.

Focusing on the Individual

The focus of all approaches is to assess an individual’s needs and preferences. A

therapeutic approach towards an individual focuses on seeing the person as a ‘whole
person’ and considers how to offer opportunities wider than meeting just their physical
needs, which will enhance someone’s well-being. As a care worker this too is an
important part of your role and it would be useful to talk with your manager and
colleagues about how the care setting, where you work, aims to provide all of these
approaches to meet the holistic needs of the individual in your care. Care workers
make judgments about what the people in their care are thinking and feeling all the
time, without being aware of it. They often base these judgments on guesses and
hunches and on what they have been told about the person by someone else. It will
be better for all concerned if care workers learn to base their judgments on careful
observation of the person.
Approaches that demonstrate person-centred care:
• It is the right of each person to be treated as an individual. This will make them
feel valued and respected. You, as a care worker, can achieve this by the way
you treat the individuals.
 • Always find out the name they prefer to be called. Do not assume everybody
prefers first name terms, or endearments such as ‘dear’ (this may be seen as
belittling to the individual)
• Talk with and listen to individuals, key people, and others to assess, needs,
wishes and preferences.
• Find out about their daily routine, their family and friends, hobbies, and
interests.
• Plan care holistically
• Be polite, helpful and show empathy.
• Ensure individuals have contact with family and friends.
• Encourage personal items, e.g., photographs, furnishings, ornaments etc.
• Do not clothe individuals in items that belong to the care establishments or other
individuals.
• Give choices, uphold rights.
• By looking at the individual’s past history to discover their identity

Adopting a strength-based approach

Despite a person’s illness, disability, or other limitations they will still have many
strengths and abilities. It is the role of the care team to identify these and work with the
individual to develop a strength-based approach/plan to build on strengths and
minimise weaknesses to maintain well-being.

Attitudes

It is extremely important to an individual’s well-being that care workers’ approach

towards them is supportive and that they are treated equally and with respect. The
person should be treated with unconditional positive regard. This means a person is
accepted and respected by others regardless of their condition.
It is vital that you as a care worker recognise that you have a ‘duty of care’ to all
individuals, regardless of their race, sex, religious background, and apparent lifestyle
choices. The service you provide should be delivered equally and inclusively.
A care worker who demonstrates a polite and willing attitude, and provides open and
honest communication, whilst maintaining privacy, dignity, confidentiality, and choice
will create feelings of self-confidence and self-worth - a relationship which truly values
the individual and maintains their dignity.

6.3 Identify ways to contribute to an environment that promotes well-being

Physical environment

In some care homes the building looks more like a hospital or a hotel, with long
corridors and lots of doors, rather than an actual ‘home’. Although staying in a hotel
can feel quite nice for a few weeks, imagine having to spend the rest of your life in a
hotel. To promote well-being, it is important that the environment looks homely, and
you can achieve this by the following:
 • The environment should be well decorated and well maintained.
• Have a homely atmosphere.
• Clean and odour free
• The visual environment should be well lit and have useful and helpful sign
posting.
• The visual decor and furnishings should be sympathetic to the building, wall
pictures and furnishings should be homely to avoid an institutional look.
• Have safe and secure access to the outside.
• Noise levels should be appropriate and allocated quiet areas should be
provided.

It is important that people are encouraged to personalise their own space. This could
include:

• Individual’s own belongings in their room with bed linen and soft furnishings
chosen by them.
• Cherished objects e.g., family photographs, ornaments etc.
• A favourite chair
• Favourite flowers in the garden
A person can gain comfort from items which seem to have no importance to us. What
matters is not what the item is but how it makes the person feel.
The environment in the individual’s own home should also be considered. Their home
may have undergone considerable changes to accommodate their needs. This could
range from rearranging furniture, moving their bad and bedroom furniture to a
downstairs room to major alterations. Aids and equipment could also be in place. This
may make the individual feel that their home no longer feels ‘homely’ and that they are
losing part of their identity.
It is important that any changes involve the individual and that they can give opinions
and make decisions. Fixtures and furnishings should be the person’s choice and where
the individual wishes, personal items should be displayed and access to items such as
handbags is extremely important, as removing these may make the person feel
anxious and insecure.

Social and emotional environment

Life is far more pleasant, and the time spent in another’s company far more rewarding,
if people feel valued and respected. Forming a good relationship will help individuals
socially, mentally, and physically. Good, honest, and open communication with people
creates a positive, therapeutic atmosphere, and high standards of care reflect this.
To create a positive social and emotional environment, it is important that you:
• Always maintain dignity and respect.
• Encourage expression of needs, wishes and preferences and endeavour to
meet these.
• Create relaxed, sociable occasions which will give the individual time to build
relationships.
 • Having a cup of tea with the individual could give opportunities to build
relationships with yourself, the individual and others.
• Treat the person as an individual.
• Modify the level and pace of your communication to suit the client.
• Use appropriate and respectful language.

Being cared for probably makes a person feel very vulnerable. Encourage individuals
and their family/carers to speak with you, answer their questions and give information,
explanations, and reassurance. The main message the individual will want to hear is
that they are in control of what happens to them, and that the care they receive is
planned in partnership with them and key people. This will make them feel empowered
and they may be more willing to accept the care they need.

Subjective feelings

It must be remembered that individuals do not always view things objectively and that
feelings are very subjective. It may not always be possible for individuals to view things
in the way that others see them or experience feelings as others believe they should.
A care worker may be working extremely hard to meet an
individual’s needs, carrying out all care interventions to a
very high standard, in a pleasant, polite way, only to be
met with anger and resentment from the individual. Even
though the individual realises that the care worker is trying
their best and that they should be polite to them, all they
may feel is resentment, frustration, and anger at their
situation. Similarly, even though the care worker may
understand the individual’s feelings and that the anger
directed at them is not personal, they may still feel hurt,
undervalued, or even angry.
Therefore, it is important to understand that feelings are subjective, even when we can
understand how we should feel, we may not feel that way. Feelings are as individual
as we are.

Maintaining appropriate professional relationships with individuals

You, as a care worker, must be aware of the boundaries of your relationship with
individuals. Forging a close friendship or intimate relationship, delving into their private
life, or making personal comments or remarks, is unacceptable. The person may be
made to feel uncomfortable and anxious. A relationship that is inappropriate makes
individuals vulnerable; it breaches your contract of employment and legislation. An
appropriate therapeutic relationship will enable you to carry out your work activities
effectively.
There needs to be an acceptable balance of power in any relationship. Vulnerable
adults need support and not to be told what to do. The partnership begins when
individuals are encouraged to make their views and choices known during
assessment. They have a right to be listened to and be given the opportunity to
express themselves. By being given the chance to identify their preferences they are
retaining an element of control in their lives. This in turn boosts self-esteem and self-
worth; they have a degree of independence and involvement in the decision-making
process relating to their lifestyle and choices.

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now complete and upload the activities, workplace tasks and reflective
journal before proceeding onto the next unit.
Unit 8 Understanding Health and Safety in Social Care Settings
R/602/3179.

Unit purpose and aims

This unit is aimed at those who are interested in, or new to, working in a social care
setting. It introduces knowledge and understanding of areas of health and safety
required to work in a social care setting.

Learning Outcome 1

The learner will:

Understand the different responsibilities relating to health and safety in social care
settings.
The learner can:

1.1 List legislation relating to general health and safety in a social care setting
1.2 Describe the main points of health and safety policies and procedures.
1.3 Outline the main health and safety responsibilities of:
a) The social care worker
b) The employer or manager
c) Individuals
1.4 Identify tasks relating to health and safety that should only be carried out with
special training.
1.5 Describe how to access additional support and information relating to health and
safety.

1.1 List Legislation relating to general Health and safety in a social care setting

The framework of legislation is based on Acts of Parliament being passed and

Regulations, Codes of Practice and Guidance being made under these to explain, in
greater detail, the requirements of the Act itself.

• The Health and Safety at Work Act 1974 (HASWA)

• Management of Health & Safety at Work Regulations 1999
• Manual Handling Operations Regulations 1992 (amended 2002)
• Control of Substances Hazardous to Health 2002 (COSHH)
• Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013
(RIDDOR)
• Food Safety 1990
• Food Hygiene Regulations 2006 (England)
• The Personal Protective Equipment Regulations
• Health and Safety (First Aid) Regulations (1981)
• Lifting Operations and Lifting Equipment Regulations (1998) (LOLER)
• Provision and use of Work Equipment Regulations 1998 (PUWER)
• The Medicines Act 1968
• The Misuse of Drugs Act 1971
The employer has a duty to carry out an assessment to provide suitable first aid
arrangements. Employees should be informed of these arrangements. Your workplace
will have either first-aiders or appointed persons. Their names and location should be
displayed on the notice board.

1.2 The main points of health and safety policies and procedures

Organisational safety and security procedures

To keep the workplace safe and secure, employers write policies and develop
procedures to be followed by their employees. The Health and Safety at Work Act
(1974) requires employees to draw up a Statement of Health and Safety Policy, to tell
all employees about it and to revise it as often as necessary. This applies to all
employers who have five or more employees.

Health and Safety Policy Statement

‘An employer (of 5 or more people) should prepare (and revise when necessary) a
general statement of policy with respect to health and safety at work and in particular
outline the organisation and arrangements which have been implemented to ensure
that the policy is being carried out’.

This means a company should write down the arrangements in place for ensuring that
the health & safety of its employees are considered in the day to day running of the
business.

The policy should include:

• All significant risks

• All controlled measures assessed for hazards.
• Methods for report hazards or health problems
• Procedures for first aid fire and emergencies
• Methods of all reporting procedures

The policy should be in writing and brought to the attention of all employees. It should
clearly define the roles and responsibilities of individuals and managers for health and
safety. It should be signed by the most Senior Manager within the Company in order
to show commitment.

1.3 The main health and safety responsibilities

The Health & Safety at Work Act places responsibilities on both employers and
employees to ensure compliance with health & safety.
Duties of Social Care Worker (Employee)

Employees should:

• Take reasonable care of their own health and safety and that of others who may
be affected by their acts or omissions.
• Co-operate with the employer on matters of health and safety and follow
workplace procedures.
• Correctly using, and not misusing or interfering with, anything provided for
health, safety, or welfare. Procedures have been developed to ensure that
equipment and materials are used safely, to prevent injury to the worker, client,
or visitor. The manufacturers also provide information on the equipment and
documentation.
• Portable electrical equipment [PAT] must be checked annually to ensure
functioning correctly, that the wiring is intact and safe and correct fuses
installed. The employee is responsible for visually checking prior to using the
equipment. Is the plug cracked or damaged, any loose parts and is the cable
intact so that wires cannot be accidentally touched?
• Take part in Health and safety training.
• Report any potential hazards and risks.
• Understand and comply with health and safety procedures.
• To report any accident or incident that may occur, whether anyone sustained
injury
• To work in a safe manner
• Use the PPE provided and do so correctly.

Duties of the Employer

An employer should ensure, so far as it is reasonably practicable, the health, safety,

and welfare of all employees. This section requires the employer to:

• Provide and maintain systems of work that are safe and without risk to health.
• Provide and display safety signs.
• Make arrangements to ensure that substances (e.g., solvents) can be used,
handled, stored, and transported safety.
• Provide information, instruction, training, and supervision to ensure health,
safety and welfare of employees.
• Maintain the place of work in a safe condition and without risk to health and to
ensure that means of access and egress to and from the place of work are
provided and maintained in a safe condition.
• Provide and maintain a safe and healthy working environment and provide
adequate welfare facilities.
• Providing equipment and premises that are safe to use.
• Provision of first aid facilities
• Training and supervision in health & safety matters
• Outlining procedures for dealing with fires
• Adequate provision for the safe storage of goods
• Providing protective clothing when necessary
 • Making regular audits and assessments of workplace activities
• Providing a written statement of Health & Safety if 5 or more people are
employed.
• Arrangement of adequate insurance cover for employees and the public
• Providing a safe environment for all

Duties of the individual (someone requiring care or support)

• To comply with health and safety instructions and procedures

• To take reasonable care of their own health and safety and the safety of others
• Not to misuse anything that is provided for health and safety.

1.4 Tasks relating to health and safety that require specialist training

Tasks that the learner should not carry out without special training may include those
relating to:

• Use of equipment
• First aid
• Medication
• Moving and handling
• Emergency procedures
• Food handling and preparation

Under the Management of health and safety at work regulations, Regulation 13: ‘The
employer must ensure individuals are appropriately trained to carry out their duties’.

Many pieces of legislation require an employer to ensure that staff has received
appropriate training.

Induction Training

This type of training should be carried out when a person joins a company for the first
time. Health & Safety should form an integral part of any existing Induction training
package. Topics to be covered include emergency procedures such as fire precautions
and evacuation, first aid arrangements, accident reporting, procedure, and company
safety policy.

Job Specific

The extent and complexity of training will depend upon the job being carried out. It is
important to consider a period of supervision, especially if the employee is a young
person or has any learning difficulties.

Ongoing Training

It is important to introduce a periodic refresher or update of skills (e.g., moving and

handling techniques) to ensure that employees continue to practice safely.
A programme of regular health and safety training can be used to advise employees
about:

• Any new hazards and risks

• The results of risk assessments
• Control measures to reduce risks.

Specialised Training

Some jobs require individuals to be highly skilled and ‘competent’. A competent person
is defined as a person who has specialised knowledge of the issues concerned, who
may have a recognised qualification and experience but above all knows their own
limitations. Within this area are included medication training, food handling and
preparation and first aid.

A first aider is someone who has undergone a training course in first aid at work and
holds a current first aid at work certificate. An appointed person is someone who
looks after first aid equipment and takes charge when somebody is injured or is taken
ill in the workplace.

Training Records

It is important to have a formal way of recording any training that employees receive
during their employment. This will not only assist in ensuring that persons are
appropriately trained to carry out their relevant tasks, but may be of use should an
incident occur, or worse still a compensation claim. If an accident occurs in your place
of work, the HSE or EHO may ask for training records to verify if the injured person
received appropriate training, or whether lack of training was a contributory cause of
the accident.

1.5 Accessing additional information and support

Information and support relating to health, safety and dealing with incidents and
emergencies will be stored in a variety of places. It is important that you know where
relevant information is, and how to gain access to it. This will help inform and develop
your practices. Sources may include:
• Workplace – policies, procedures, publications
• Trained professionals – e.g., doctors, nurses, occupational therapists, health
and safety representatives, first aiders, manager
• Internet – ensure source is reliable.
• Library
• Manufacturer’s instructions and data sheets
• CQC
• The Health & Safety Executive (HSE)
Learning outcome 2

The learner will:

Understand the use of risk assessment in relation to health and safety.

The learner can:

2.1 Define what is meant by ‘hazard’ and ‘risk’.

2.2 Describe how to use a health and safety risk assessment.
2.3 Explain how and when to report potential health and safety risks that have been
identified.
2.4 Describe how risk assessments can help address dilemmas between an
individual’s rights and health and safety concerns.

2.1 Defining hazard and risk

Hazard - something with the potential to cause harm, death, ill health, injury, loss of
production or damage to property.

Risk - entails the likelihood of injury, damage or harm arising, considering any
preventative measures already in place.

For instance, a sharp knife left in a washing up bowl is a hazard, receiving a cut from
putting your hand in is the risk, a control measure is not to leave sharp knives in the
bowl.

Risk Assessment

A risk assessment may be defined as an identification of the hazards present and an

‘assessment’ of the extent of the risk involved, considering whatever precautions are
already in place.
Where five or more persons are employed, that assessment must be written down.
There are “Five Steps to Risk Assessment”.

1 Identify all the hazards.

2 Decide who could be harmed.
3 Evaluate the risks and decide if existing control measures are adequate.
4 Record the findings.
5 Review the assessments at regular intervals.

The format for recording the assessment may be one that suits your organisation.
2.2 How to use health and safety risks assessment

To achieve a suitable and sufficient risk assessment it is essential to identify all the
hazards associated with the activity.

The following list is a guide to some of the hazards, which need to be considered when
identifying hazards for the purpose of risk assessment.
• Slipping/tripping hazards
• Fire
• Loose or trailing cables
• Storage of boxes and files
• Manual Handling
• Noise
• Poor lighting
• Electricity
• Housekeeping
• Chemicals

This is not a comprehensive list but is given to illustrate the extensive nature of hazards
which may need to be considered.

Evaluation

Evaluate the risks arising from the hazards and decide whether existing precautions
are adequate or more should be done.
For each activity, a risk assessment must be carried out. To estimate the extent of the
risk, use guidance material (e.g., a manufacturer’s handbook supplied with a machine
will tell you of potential hazards), information and your own experience.
Risk is a combination of three factors:
• The numbers of people who could be affected
• The severity of likely injuries that persons could suffer
• The likelihood of harm occurring

The overall risk score is calculated using the following formula:

Risk rating = numbers x severity x likelihood

Assessing risk should be systematic, ensuring all aspects are covered, addressing
what actually happens and considering existing, preventative (control) measures.
The following questions should be asked:
Do the precautions…
• Meet the standards set by a legal requirement?
• Comply with recognised industry standard?
• Represent good practice?
• Reduce risks as far as is reasonably practicable?
If it is found that something needs to be done, ask:

• Can the hazard be removed altogether?

• If not, how can the risks be controlled so that harm is unlikely?

Once the risk has been assessed, it must then be decided how to eliminate, reduce,
or control it.

If your organisation has fewer than five employees, you do not need to write anything
down, but you still need to assess the risk. Five or more employees means that you
must record the significant findings of your assessment. This means writing down the
more significant hazards and recording the most important conclusions.

2.3 How and when to report potential health and safety risks that have been
identified

It is important that you know when and how to report potential health and safety risks
that have been identified. It is the responsibility of all employees to report risks, even
if that employee is in a junior position. Reporting a risk will ensure that the health and
safety officer and /or manager/employer is aware and is able to assess the risk. Even
if a written risk assessment is in place, you must report any risks that develop due to
any hazards identified changes that occur or if control measures are inadequate.

Your workplace will have policies and procedures about the processes required to
report potential or actual risks to health and safety. Your role within the organisation
will determine who you report this risk to and how you do this. It is likely that if you are
new to care or in a junior position you will report the risk to a designated senior
colleague e.g., your manager, a trained nurse, or the health and safety officer.

It is good practice for you to make a written record of the potential/actual risk identified
and when and to whom you reported this. Indeed, it is likely your care organisation will
require this.

Faulty equipment should be removed from use, clearly labelled and a written report
made. Any environmental risks (e.g., loose tiles, rugs etc.) should be reported, the
hazard removed if possible, and all those within the care setting protected from the
risk. This may be done using signage, cordoning off of the area and requesting urgent
repairs or replacement.

The manager or health and safety officer will then follow legal and organisation
processes to report the risk.
It is important that you appreciate that reports must be clear and accurate. There is
little to be gained from a report that is not understood or that gives a false impression
of the situation or has vital details omitted.
2.4 How a risk assessment can help address dilemmas between an individual’s
rights and health and safety concerns

Risk Assessment and addressing dilemmas

Take account of others

It is the right of every individual to be treated equally and not be discriminated against.
You have a duty of care to actively support the individuals to access their rights by
ensuring you and others uphold these rights. You must do this by giving information
and guidance, and reporting any concerns immediately, acting on behalf of the
individual if necessary. Everyone is entitled to the full protection of the Health & Safety
at Work Act, along with related legislation, local and organisational policies and
procedures.
The needs, wishes and preferences of individuals should be considered, whilst you
ensure your own safety, the safety of individuals and key people such as:
• Family
• Friends
• Carers
• Others who provide support

Example:
It may be acceptable for individuals to smoke in designated areas. However, an
individual who wishes to smoke in bed would pose an unacceptable risk to themselves
and others, and this should not be permitted.
You, as a care worker, can encourage individuals to express their needs and wishes
by listening to what they want, discussing all aspects of care with them, offering
explanations and reassurances, and communicating at a manner, level, and pace
appropriate to their needs. Individuals should be encouraged to assess their own risks
with support and take responsibility for their health and well-being.

Conflict

There may occasionally be a conflict of interest regarding health and safety issues.
This may occur between team members, individuals, key people, care workers and
others. Resolving this conflict must never compromise health and safety. It is essential
that you explain the reasons for and the process for risk assessment and involve those
concerned in its development to promote understanding and encourage co-operation.
There may be areas of conflict that you have encountered. For example, an immobile
individual and their carers may decide they do not wish to use recommended moving
and handling equipment such as a hoist, and this may result in the client being lifted
manually, or colleagues may lift manually as they feel this is quicker. You must remind
colleagues of their responsibilities under current legislation, that they face disciplinary
action if they persist and that you will record and report unsafe practices. Discussion
and re-education may be sufficient to resolve this conflict.
In the case of the individual and informal carers, the potential risks and dangers of their
action and the possible consequences to all concerned must be discussed and related
to the risk assessment. The use and benefits of equipment should be clearly explained,
and reassurances given. Resolution may be reached if the individuals concerned
agree to use the equipment or the use of suitable alternative equipment is agreed.
However, you must not agree to do anything you know is unsafe and must discourage
others from doing so. Reporting this conflict, seeking advice, and making a record is
vital. Each person has the right to choose to accept the consequences of their actions,
but no-one has the right to compromise the health and safety of others.

Learning outcome 3

The learner will:

Understand Procedures for responding to accidents and sudden illness.

The learner can:
3.1 Describe different types of accidents and sudden illness that may occur in a social
care setting.
3.2 Outline the procedures to be followed if an accident or sudden illness should occur.
3.3 Explain why it is important for emergency first aid tasks only to be carried out by
qualified first aiders.

3.1 The different types of accidents and sudden illness that may occur in a
social care setting

Emergencies can be described as situations involving an immediate and threatening

danger to individuals and others.
Incidents are defined as occurrences that require immediate attention to avoid
possible danger and harm to people, goods and/or the environment.
When emergencies and incidents take place, it is essential that you know what to do
and that you can take immediate and appropriate action.
Emergencies situations include:

Explosion
• Fire
• Flood
• Serious damage to the building
• Health emergencies
Incidents could be:
• Intruders
• Chemical spillages
• Lost keys, purses etc
• Missing individuals
• Individuals locked out
• Contamination risk
• Aggressive and dangerous encounters
• Bomb scare

Possible accidents and sudden illnesses could be:

• Slips, trips and Falls

• Burns and scalds
• Inhalation and swallowing of hazardous substances
• Stroke
• Breathing difficulties
• Hypoglycaemia
• Seizures
• Loss of consciousness/fainting
• Food poisoning
• Cardiac arrest
• Sudden and severe chest pain
• Lifting and handling
• Physical assault

3.2 Procedures to be followed if emergencies or accidents occur

The urgent nature of emergencies and many incidents means that it is essential that
the action you take is provided without delay. Because of this, you must be prepared
to deal with these situations, so that you do not waste valuable time if they occur. Fire
drills and practice emergency evacuations will help you to be ready to deal with some
of the emergencies and incidents that may occur.
Training and a good understanding of organisational policies and procedures will
prepare you to respond to other situations.

Provide support and assistance and make the area safe

When health emergencies occur, care workers may
provide complete First Aid care or call for help and follow
the instructions of a more qualified person. The care you
provide will vary according to the type of emergency and
your training, knowledge, and experience in dealing with
emergencies. The more experienced person or
ambulance may take a few minutes to reach the scene
and you will need to provide the casualty with
reassurance and any immediate help or first aid that you feel confident in providing.

First Aid terms

D- Danger (look for danger) B- Basic

R- Response (ask the casualty to L- Life

respond)

S- Shout- call for help S- Support

A- Airway – check airway

B- Breathing – check breathing

C- Circulation - check circulation

Cardiac arrest (the person is unconscious, and you are unable to detect a pulse or
breathing)
This is a life-threatening situation, failure to commence basic life support – BLS - within
3 minutes, will cause severe oxygen deprivation and death may be the inevitable
result. Only carry out actions that you have been trained in are able to do safely without
causing the individual harm.
Performing CPR - St John’s Ambulance guidelines:

1. Call 999/112 for emergency help. Ask a bystander to locate an AED.

2. Kneel beside the casualty. Place one hand on the centre of the chest. Place
the heel of the other hand and interlock them to lift them off the chest.

3. Begin chest compressions by leaning your body weight over the casualty with
arms straight. Press downwards on the breastbone to a depth of about 5-6cm.
Release pressure but keep your hands in place. Try to perform compressions
at a rate of 100-120 per minute. Perform 30 chest compressions.

4. Perform two rescue breaths by opening the airway and pinching the nostrils
together. Take a breath and blow air into the casualty’s mouth until the chest
rises.

5. Repeat the cycle of 30 compressions and two rescue breaths until help arrives.

Other health emergencies may include:

• Shock • Electrocution
• Epileptic seizure • Faints or loss of consciousness
• Choking and breathing difficulty • Burns and scalds
• Poisoning • Severe bleeding
• Fractures, actual or suspected
When professional help arrives, you should give information to the paramedic, doctor
or nurse about the circumstances of the injury or illness and the treatment that has
been given already. It is also important that you think the safety and privacy around
the person during the emergency.

Safety

You should always assess the situation that the casualty is found in and pay particular
attention to the safety of yourself, the casualty, and other people in the area.
You should take charge of the situation in a calm way, ensuring that the cause of the
injury does not create further harm. This can be done by:
• Switching of the current, in the case of electric shock
• Moving the casualty to safety, if there is a risk from fire or the collapse of the
building.
• Removing furniture or equipment that is in the way.

Privacy

The casualty’s privacy should be protected as much as possible. When someone has
been taken ill, they do not want to be looked at by others who have no need to be
around, and it can add to the distress and anxiety felt by casualties when they are the
focus of unnecessary attention. You can protect the privacy of the person with the
emergency by asking bystanders to leave the area and restricting entrance to the
surroundings until the casualty can be moved.

Supervision

When several people respond to an incident or emergency it is vital that they work
together as a team and that they understand their individual roles. The key to this is
the use of appropriate supervision. The person in charge of the situation can ensure
that:
• Someone calls for any assistance required.
• The most appropriate individual(s) administer First Aid.
• The safety and privacy of the area is maintained.
• Changes in the situation are responded to.
• The handover to the emergency services is effective.

When the casualty has received appropriate help, others (clients, staff, and visitors)
may also need support because they helped to deal with the emergency, witnessed
the incident or they may have been ‘close’ to the casualty.
Being involved in an emergency and being concerned about the well-being of a
casualty can be both stressful and distressing. You should be as supportive as
possible to everyone involved and remember that the incident may have an emotional
effect on you too. If you or others involved in the incident require extra support to
manage stress and prevent distress, you should seek the advice of your manager.
Report and record incidents, accidents and emergencies

All incidents and emergencies whether they involve staff, individuals or visitors must
be reported immediately to the manager. Reports made must be accurate and
complete so that those who receive them have a clear understanding of the incident
or emergency, any injury that was caused and the action that was taken in response
to it. It is a legal requirement that all accidents are reported and investigated.

Employers are required to keep a record of all accidents this could in the format of an
accident book or completed online.

The information that should be recorded includes:

• Personal details

− Name
− Address
− Occupation

• Details of the accident such as:

− The date and time of the accident

− The place and circumstances of the accident
− Location of others involved, (staff, clients, visitors)
− The type of injury
− The treatment that was given

• Details about the entry

− Who made the entry in the accident book or online

− The date when the entry was made

All records and reports should respect confidentiality, be accurate, legible, and
complete, and conform to organisational and legal requirements. Details of any
incident, accident or emergency involving am individual should also be recorded in
their care plan.

Accident reports and employer responsibilities

Records of accidents should be used as part of the risk assessment process, to identify
the types of accidents that occur in the workplace and to help employers to recognise
risks and take action to reduce them. An accident investigation must be completed at
the earliest opportunity. The purpose of this is to establish what caused the accident
and what caused the injury. By completing a full accident investigation, it can be
possible to remove the risk of the same accident happening again by changing the
procedures, working practices, or instigating repairs to the machinery or the fabric of
the building.
The legal requirement to report incidents and emergencies is identified in RIDDOR –
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013.
Under these regulations, the ‘responsible person’ in the workplace must notify the
relevant authority about:
• The death of any person because of an accident
• Major injuries sustained by people.
• Occupational diseases
• Injuries that result in the casualty being taken to hospital
• Dangerous occurrences
• Gas incidents

Employers must report any listed injury, dangerous occurrence

or disease to the Health and Safety Executive (HSE) or local
authority. The preferred method of reporting is online using the HSE website, however
there is a telephone service provided for individuals to report fatal and specified injuries
only, which is the Incident Contact Centre (ICC) who can be contacted on
0845 300 9923. Reports made in this way will be recorded and a copy of the report
will be sent to the employer.

3.3 Why it is important for emergency first aid tasks only to be carried out by
qualified first aiders

It is important that only qualified first aiders carry out first aid because:
• It will comply with Health and Safety regulations and will meet organisational
policies and procedures.
• By treating illness and injuries effectively will reduce the consequences and
preserve life

The aims of First Aid are to:

• Preserve life.
• Prevent deterioration.
• Promote recovery.

It is important you know your capabilities in an emergency. If you are unsure of what
is expected of you, or are unsure of first aid procedures, discuss this with your manager
immediately.

It is important that you understand the aims of first aid in order that you are aware of
why it is vital that emergency first aid tasks are only carried out by qualified first aiders.
Failure to administer first aid immediately and effectively can lead to poor recovery,
deterioration, or even death. Others involved may be exposed to unnecessary risk if
procedures are carried out incorrectly or mistakes or omissions occur. A care worker
may also find themselves the subject of a complaint and/or legal proceedings.
Learning outcome 4

The learner will:

Know how to reduce the spread of infection.

The learner can:

4.1 List routes by which infection can get into the body.
4.2 Describe ways in which own health or hygiene might pose a risk to an individual
or others at work.
4.3 Explain the most thorough method for hand washing.
4.4 Describe when to use different types of personal protective equipment.

4.1 Routes by which infection can get into the body

There are 5 ways in which infection can get into the body and they are:

• Through touch – directly touching the skin.

• Through the air– some infections are airborne and can enter the body by
someone coughing and sneezing.
• In blood – needlestick injuries, animals, or insect bites
• Body fluids – directly via contact with an individual and indirectly via
contaminated equipment
• Through ingestion – contaminated food causes food poisoning

4.2 Ways in which own health or hygiene might pose a risk to an individual or
others at work

Care worker health and hygiene

When working in a health care environment, it is essential that you are fit to perform
your role safely and effectively without risk to your own or other people’s health and
safety. Therefore, it is important that workplace policies and guidelines on staff
infection and work restrictions are adhered to. Should you or your family be suffering
from any kind of infection, advice should be sought from your GP and/or manager
about returning to work. Many employers recommend that you stay away from work
for a further 48 hours after illness has ended to ensure that you are free from infection.
Some employers will ask for further health checks before allowing you back to work in
areas where your illness could put patients at increased risk. It is important to
remember that infection can be carried in the body for weeks after symptoms disappear
and it is important that these infections are not passed to vulnerable people.

The Covid-19 pandemic of 2020/2021 has resulted in several changes in relation to

health & safety and infection control. It is important to keep up to date with the
government guidelines as advice changes frequently. Some of the measures include
keeping 2 metres apart where possible, extra use of PPE, frequent testing, an increase
in cleaning regimes and temperatures taken and recorded on a regular basis. Staff will
have to self-isolate for a certain period of time before returning to work if they have
symptoms or have a positive test result.

Employers can ask staff to perform tests prior to starting work to ensure a negative
test result is achieved. Lateral flow tests are rapid tests which can be performed at
home or at work and results come back within 30mins. PCR tests require taking a swab
which is sent away to a lab for testing and results come back within a few days.

Care workers who have pain or injury to the back and joints, infection or are pregnant
must seek the advice of their manager, as their health and safety and that of others
may be affected.

Frail, ill individuals are particularly vulnerable to infections transmitted by poor hygiene
and contagious diseases. Colleagues and others may also transmit infections following
exposure to a care worker’s poor health and hygiene.
You, as a care worker, will be handling and disposing of waste contaminated with
bodily fluids during your work. It is important that you protect yourself, the individuals
and colleagues from transmitting infection this way.

4.3 The most thorough method for hand washing

The single most important and neglected aspect of the control of infection is attention
to the basic rule of frequent and thorough hand washing.
Correct hand washing sequence
4.4 When to use different types of personal protective equipment

Personal Protective Equipment (PPE) means all equipment or clothing which is to be

worn at work and which offers protection against one or more risks to health and safety.
Personal Protective Equipment should not be confused with a works uniform, e.g.,
nurses’ uniform or shop assistants’ overalls. That is provided as part of the company’s
‘image’ and is not covered under the PPE regulations.

The use of PPE to protect people is the last line of defence and other measures to
control the hazards and risks involved should be considered first. All too often there is
not enough effort put into reducing or eliminating hazards and too much reliance is
placed on the use of Personal Protection to prevent the hazards causing injury or ill
health.

The employer has a duty to ensure that if PPE is provided for protection against a
known hazard that the ‘user’ wears this. Regular supervision is important and if
necessary, a disciplinary procedure should be introduced for people who refuse to
wear the agreed protection. As individuals have a duty to comply with the employer’s
health and safety arrangements, it would be considered a breach of health and safety
law if the employee refused to wear specified PPE.

• Apron – protect the wearer from being contaminated, for example, waster
matter. Also protects individual from contaminants present in uniforms and
clothes.

• Gloves – prevent the wearer from contaminating sterile areas or protect wearer
and others from contamination.

• Masks protect the wearer and others from airborne pathogens or splashes from
contaminated matter.

• Face Shields/Visors – provide a protective barrier from airborne viruses.

Learning outcome 5

The learner will:

Know how to move and handle equipment and other objects safely.
The learner can:
5.1 Identify legislation that relates to moving and handling.
5.2 List principles for safe moving and handling
5.3 Explain why it is important for moving and handling tasks to be carried out following
specialist training.

5.1 Legislation that relates to moving and handling.

• Health and Safety at Work Act 1974

• Manual Handling Operations Regulations 1992 (amended 2002)
• Provision and Use of Work Equipment Regulations 1998
• Lifting Operations and Lifting Equipment Regulations 1998

These regulations concern the moving of objects within the activities carried out at
work. This includes any type of physical movement such as:
• Pulling
• Pushing
• Lowering
• Lifting

The employer is expected to avoid the need for manual lifting, wherever this is
possible. A risk assessment should be carried out, efforts made to minimise the risk
of injury and the need for equipment identified. All care staff should be fully trained to
move and handle and use equipment safely. This will reduce the risk of injury to staff,
individuals, and others. In addition, these regulations include numerical guidelines to
help determine when assessment is required.
Guidelines advise that all individual handling should be assessed, taking into
consideration all aspects, not just weight. Lifting of people should never be done and
this includes the use of slide sheets to lift clients, rather than turning or rolling.
The message is clear – DO NOT LIFT CLIENTS MANUALLY!

Local and Organisational Policy

Every care organisation should have an organisational policy and procedures, based
on the Manual Handling Regulations and local policy. All staff should be aware of this
and know where to locate the information. Your organisation should have supplied
you with a copy of the policy and you should have a clear understanding of you and
your employer’s responsibilities.
5.2 Principles for safe moving and handling

Moving and handling

You must use, and support others to use, safe procedures and techniques for moving
and handling. Moving and handling activities may be conducted manually or using
equipment and may be used to lift, move or handle:

Materials

• Other items
• People

Employers are required, by The Manual Handling Operations Regulations 1992, to

carry out risk assessments for all moving and handling activities; this includes the
laundry, kitchen, and the office, as well as for individual clients.
The result of these assessments should provide information that ensures that lifting
and moving of heavy loads is avoided. Employees are required to read and follow
these assessments.
This risk assessment should include the following areas:

• L Load – this includes weight, centre of gravity, the temperature, any

attachments such as catheters, the shape and size of the load, how co-
operative the load is.
• I Individual – includes height, weight, age, fitness, gender, training,
attitude, ability and capability, clothing, and shoes
• T Task – how often do you do the task, look at the distance, speed, and
positioning, do you have to twist, stretch, or reach, what equipment do you have
to help you.
• E Environment – look at space, noise, stairs, obstacles, ventilation,
humidity, floor surface, and are you inside or outside

The following points are important and should be always observed:

• Before any load, whatever it is, is moved or handled, a full assessment of the
risks involved must be undertaken.
• Do not lift manually if the load appears too heavy. This will include the people
you care for, who should not be lifted manually unless in exceptional
circumstances (e.g., falls in places inaccessible to a hoist or certain life-
threatening emergencies). You should have received training in safe techniques
and summon the help of as many people as possible.
• Following training, always use the equipment provided where this is advised.
• Always check that any equipment you use is clean and in good working order.
• If you are unsure, you must seek advice from your manager before attempting
the task.
• Do not attempt any moving and handling task you feel may result in injury to
yourself or others.
• Always bend your knees when lifting and keep your back straight.
 • Stay close to the load; don’t stretch to reach it.
• Feet should be slightly apart with one foot slightly in front of the other. This will
spread the weight of the load.
• Hold the load firmly - if dropped it could injure your feet and cause damage to
the item.
• When putting a load down, bend the knees and keep your back straight.

Remember to practice this at home as well as at work!

If you need to reach items beyond your normal height, always use stepladders or
purpose-built equipment. Never use a chair or stand on boxes, shelves etc.
There are 10 basic principles for safe lifting and handling, and they are:

• Good foot position – is your balance and stability good.

• Face in line with movement – this will reduce twisting which can injure your
back.
• Back “straight” – reduces lumbar pressures.
• Avoid twisting - move your feet – prevent lower disc stress.
• Bend your Knees – this ensures you use the large muscles in the tops of
your legs.
• Firm grip – will give you more control.
• Hold close – this lowers the pressure on the spine.
• Raise your head – so you can see where you are going and helps to keep
your back straight.
• Lift in stages if necessary – your muscles will work better with rest.
• Lower carefully – this will prevent ‘whiplash’ type injuries when you release.

5.3 Why it is important for moving and handling tasks to be carried out
following specialist training

It is important that moving and handling tasks are carried out only after having
specialist training because:

• It is the law.
• It helps to prevent Back injuries.
• Promotes the Safety of your clients, yourselves and your colleagues.
• Limits Compensation claims for back injuries.

All staff should be provided with training appropriate to their needs i.e., all staff should
be fully trained in moving and handling objects. In addition, care workers require
further training in working with people.

Anyone who needs to use equipment to lift, move or handle objects or people must be
given appropriate training to use the equipment safely. There may have a variety of
moving and handling aids and equipment in a care setting. It is essential that you are
fully aware of their purpose and use.
It is vital that you understand your role and responsibilities regarding moving and
handling. You must be clear about what you are responsible for, and whom you are
accountable to. You must always operate within the limits of your role and
responsibilities. Undertaking tasks or using equipment you are not trained for could
have disastrous consequences. You are accountable to the individuals, colleagues
and the care organisation and may face disciplinary procedures or even civil or criminal
proceedings if you fail in your responsibilities.

Learning outcome 6

The learner will:

Understand the principles of assisting and moving an individual.

The learner can:

6.1 Explain why it is important to have specialist training before assisting and moving
an individual.
6.2 Explain the importance of following an individual’s care plan and fully engaging
with them when assisting and moving.

6.1 Why it is important to have specialist training before assisting and moving
an individual

The reasons discussed in learning outcome 5.3 also apply to this learning outcome.
The principal reason being the protection and safety of all those involved. As a care
worker you should have specialist training to undertake a variety of moving and
handling activities. If you encounter any moving and handling activities and/or
equipment for which you have received no specialist training, you should not proceed.
Report to your manager who will arrange training for you.

Specialist training promotes good practice and prevents poor practices.

As well as “manually” lifting people, bad practice can also include:

• Failing to assess the person and treat as an individual.

• Incorrect / inappropriate use of technique / equipment.
• Failing to enable the person.
• Not checking the equipment prior to use.
• Not reporting faults with equipment.

6.2 The importance of following an individual’s care plan and fully engaging
with them when assisting and moving

A care plan may be known by other names (e.g., support plan; individual plan). It is
the document where day to day requirements and preferences for care and support
are detailed.
Within the individual’s care plan there should be a moving and handling risk
assessment. The risk of injury must be assessed if the hazardous activity cannot be
avoided.

Using the individuals care plan is essential to ensure that you can follow and implement
the plan giving care in an effective and consistent way. This will ensure that the
individual’s needs are fully met. In addition, the care plan should be used to review the
individual’s condition and capabilities and the interventions planned. This will evaluate
whether interventions are effective and identify any changes which need to be
addressed.

If you fully engage with the individual whilst assisting and moving them you will be able
to gain consent for any assistance you may have to give, to give reassurance both
from yourself and the individual that the move is safe and constantly assessing the
individual and their capabilities.

Learning outcome 7

The learner will:

Know how to handle hazardous substances.

The learner can:

7.1 Identify hazardous substances that may be found in a social care setting.
7.2 Describe safe practices for:
• Storing hazardous substances
• Using hazardous substances
• Disposing of hazardous substances

7.1 Hazardous substances that may be found in a social care settings

Hazardous substances are used in many workplaces and may lead to a range of
conditions including dermatitis, asthma, and infections. Visitors and members of the
public can also be placed at risk from their use, not just the person using the substance.

Hazardous substances come in many forms including:

• Liquids, such as cleaning chemicals

• Dusts, such as lead or asbestos.
• Fumes, such as soldering fumes
• Gases, such as carbon monoxide
• Living organisms, such as fungal spores
• Bodily fluids
• Medication
It is important that you know what types of substances you may encounter or are
already using. The supplier of the substance should provide a hazard data sheet
(Material Safety Data Sheet – MSDS), which contains all relevant information for that
substance. It will indicate if it has any hazards.

You can also check the container or packaging for warning labels.

7.2 Safe practices for storing and using hazardous substances

The legislation covering chemicals is the Control of Substances Hazardous Health regs
2002, called COSHH and pronounced ‘cosh’. It states that every chemical must have
advice on safe storage, use, and what to do in the event of an emergency.

Chemicals and cleaning fluids often come in large bottles and must not be transferred
to other containers as information on the use, safe storage and emergency procedures
are clearly written on these bottles and are paramount to the health and safety of the
individual. All hazardous substances must be locked away in a cupboard designated
for this purpose. Access to these substances should be restricted to authorised
personnel.

Material Safety Data Sheets

MSDS are documents describing the known hazards associated with a material,
indicating safe handling procedures, and recommending responses to accidents and
thus are invaluable sources of safety information. They are prepared by the Chemical
Suppliers and by UK law must be sent to you if you buy a chemical but can be
requested even if you are only thinking of buying. If you already have the chemical but
the MSDS is lost or the material is so old that none came with it, most manufacturers
are happy to email a relevant MSDS on request. Many even make compilations of their
data sheets available free of charge.

Hazard symbols

The following are the symbols that appear on hazardous substances such as cleaning
fluids and other chemicals.

Explosive Corrosive Oxidising Flammable

Toxic Irritant Harmful Biohazard

Storage and safe use of substances

The following checklist is provided to help you use or handle substances safely. You
must always remember to follow your employers’ advice or procedure and to report if
any problems arise.

• Never mix different chemicals together

• Never decant chemicals into unmarked or incorrectly labelled containers
• Never use chemicals you are not trained or authorised to use.
• Always follow the correct procedures
• Always store chemicals in their designated areas which should be secure
• Always report and problems or health effects immediately
• Allow access only to authorised personnel.
• Always use any PPE indicated.

Disposal of Hazardous substances

• Wear gloves and apron.

• Dispose of in accordance with COSHH recommendations and manufacturer’s
instructions.
• Dispose of contaminated waste properly. This should be disposed of in bags
used for this purpose and collected by approved companies for disposal.
• Contaminated clothing and linen should be boil-washed separately. This is
often done after linen is placed into bags which dissolve in hot water.
• Waste containers should be stored in the appropriate area.
• The environment and waste containers should be clean/hygienic, consistent
with COSHH and policies and procedures.
• Spillages should be cleaned/removed using appropriate materials. There will
be a policy and procedure set down by your organisation. You must make sure
you are aware of this. Any spillage must be reported immediately, and a
warning sign put in place.

Bags for the disposal of waste are coded using the following colours:
BLACK - Non-hazardous waste
BLUE - Unbroken bottles and cans
RED - Contaminated linen (bags which dissolve when placed in
a hot wash)
YELLOW - Contaminated/hazardous refuse
Medication will be covered in learning outcome 10.
Learning outcome 8

The learner will:

Know environmental safety procedure in the social care setting.
The learner can:
8.1 Outline procedures to be followed in the social care setting to prevent:
• Fire
• Gas leak
• Floods
• Intruding
• Security breach
8.2 Outline procedures to be followed in the social care setting in the event of:
• Fire
• Gas leak
• Floods
• Intruding
• Security breach

8.1 Outline procedures to be followed in the social care setting to prevent

Fire, Gas leak, Floods, Intruding, Security breach

8.2 Outline procedures to be followed in the social care setting in the event of

Fire, Gas leak, Floods, Intruding, Security breach

Fire prevention

Most fire safety legislation comes under the Regulatory Reform (Fire Safety) Order
2005, which gives those with responsibility for premises a duty to:

• Take reasonable steps to reduce the risk from fire.

• Make sure that people can escape safely if there is a fire.

To do this, employers must:

• Carry out risk assessments.

• Provide detection and warning systems to alert people to fire.
• Provide firefighting equipment.
• Provide emergency routes and a means of escape.
• Develop procedures to be followed in case of danger.
• Provide fire safety information and training.
Training for all Staff

Staff should receive training in fire safety and the agreed procedure for evacuation as
soon as possible after commencing work (i.e., at Induction) and this should be ideally
updated on an annual basis.

Fire Prevention Checklist

• Ensure all escape routes and exit doors are free of obstructions and doors are
easy to open.
• Extinguishers should preferably be wall mounted and form part of a fire point.
They should not be used to wedge open doors or used as a coat stand!
• Extinguishers should be inspected by fire marshals on a regular basis, ideally
weekly, but no greater than monthly. Findings should be recorded in the fire
logbook and any discrepancies brought to the attention of the manager.
• Fire resisting self-closing doors should never be held in the open position,
unless fitted with an automatic release mechanism linked to the fire alarm
system.
• Fire alarm call points should be readily available for use, tested on a weekly
basis, from a different call point each time (not the main fire panel). All testings
should be recorded in the fire logbook.
• If you have smoke alarms fitted, these should be regularly checked. Some
smoke alarms are linked to the fire alarm systems whilst others are battery
operated. If your smoke alarms are battery operated the batteries should be
checked regularly and changed when necessary
• It is particularly important to have smoke alarms fitted where people may work
in various parts of a building, so that they can be alerted to a fire before it
spreads.
• Consider fitting smoke alarms in areas where items are stored but not regularly
inspected or visited, e.g., basement storerooms.
• A competent person should test all electrical appliances.

Fire action

In the event of a fire, you should:

• Raise the alarm.

• Dial 999.
• Inform manager/fire safety officer.
• Move self and others from danger area if safe to do so.
• Go to assembly point.
• Do not use lifts.
• Do not return to the building until told safe to do so.

Each individual in the care setting should have a personalised evacuation plan. It
should explain how to safely support each individual to evacuate the building. This
might include the use of wheelchairs and how to move bed-bound individuals.
Gas leak prevention

To prevent gas leaks, you should:

• Install a gas detection monitor/alarm.
• Regularly check to ensure good working order.
• Change batteries according to manufacturer’s instructions
• Follow your policies and procedures on prevention of gas leaks.

Gas leak action

In the event of a gas leak, you should:

• Evacuate area.
• Inform the health & safety officer/ manager immediately.
• Turn off all gas appliances.
• Turn off all electrical appliances.
• Do not switch the lights on or use a naked flame.
• Call the gas board and fire department and follow their professional advice
regarding evacuation of the premises.
• Open windows

Flood prevention

• Be aware of how to turn off the main water supply.

• Ensuring taps are turned off after having a bath or using the sink.
• Report any water leaks or damage to water pipes immediately.

Flood action

• Evacuate the area.

• Turn off the main water supply.
• Notify health and safety officer/manager immediately.
• Do not turn any switches on or off.
• Dial 999 who may suggest immediate evacuation from the building.

To prevent Security Breach/Potential Intruders

Property should be protected, and key codes limited to a need-to-know basis. Access
to the premises and areas within it should be restricted. Security should be assured,
especially at night and for those clients who have rooms on the ground floor. Valuables
should be locked away and access limited. Records should be kept. All visitors should
politely be asked for identification and the purpose of the visit checked. If you are
unsure ask the advice of your manager.
Those who appear to be under the influence of alcohol or drugs should not be allowed
entry. Do not tackle these situations alone. If you feel threatened call for assistance
immediately. Always maintain a calm and polite manner.
Intruder/security breach action
In the event of an intruder/security breach you should
• Dial 999, you should report any intruders or those trespassing in the workplace
or grounds, immediately to the Police.
• Remove yourself and others to a safe area.
• Report to your manager/safety officer
• Record the incident.

Learning outcome 9
The learner will:
Know how to manage stress.
The learner can:
9.1 Identify common signs and indicators of stress.
9.2 Identify circumstances that tend to trigger own stress.
9.3 Describe ways to manage stress.

9.1 Common signs and indicators of stress

At some point in our lives, we may all have complained about feeling ‘stressed’. Stress
arises when we feel that there are too many demands placed upon us and we feel
unable to meet these demands, so we feel unable to cope.
The Health and Safety Executive defines stress as ‘the adverse reaction people
have to excessive pressure or other types of demand placed on them’.
Signs and symptoms include:
• Feelings of anxiety, apprehension, tension, nervousness, helplessness,
feelings of being alienated.
• Physical feelings of tiredness and lacking enthusiasm
• Mood swings
• Tendency to worry more.
• Irritability
• Loss of confidence and low self esteem
• Inability to concentrate, daydreaming.
• Become more withdrawn.

When we are under excessive or prolonged stress the range of effects may include:
• Physical Effects – such as increased heart rate which may cause palpitations,
aches and pains caused by tense muscles (including headaches), difficulty
breathing, numbness or tingling sensations due to over-breathing, frequent
visits to the toilet, ‘butterflies’ or even indigestion, sleep disturbance.
• Emotional and Behavioural Effects – such as feeling tearful, tense, guilty,
moody, worried, low self-esteem, weighed down by demands, agitated, angry,
 more likely to smoke or drink, more likely to take sick leave from work or make
mistakes in daily tasks.
• Mental and Organisational Effects – such as difficulty in concentrating, being
more critical of yourself or others, poor decision making and poor time
management, feeling more sensitive to other people’s behaviour and
comments.
• Health Effects – prolonged stress may trigger health problems or make
existing health concerns worse. This can include asthma and hay
fever/allergies, rashes and skin conditions such as eczema, headaches and
migraines, stomach ulcers and diarrhoea. Heart disease is a possible effect of
long-term stress. Irritable bowel syndrome (IBS) is one of the most common
physical health effects of stress. Existing conditions such as diabetes and high
blood pressure may become less well controlled with the effects of stress.
Although this may sound worrying these health effects can be managed, and
some may be reversed, with appropriate advice from your GP about managing
stress.

9.2 Circumstances that tend to trigger own stress

The source of stress may be different for each of us as we are all individual. Stress
can affect any person at any time in their life, and is not limited to people in demanding
jobs, or those with busy lives.
Each of us may be able to identify areas of our life that we find personally stressful.
These can include:
• Relationship concerns - Family demands, juggling a job and childcare,
problems in relationships, disagreements with spouse or partner, in-laws,
parents, friends, or neighbours.
• The role that we have in life - other people have expectations of what we will
do. If we feel that we must always meet these expectations this can lead to
feelings of stress
• Financial worries
• Health worries - for our own health or those around us
• Work problems - unemployment, demands at work, problems with a colleague
or Manager, threat of redundancy, an excessive workload.
• Housing problems - threat of homelessness, stress of buying a house or moving
home, demands of maintaining a home.
• Feeling isolated or lonely
• Experiencing abuse or harassment.

Within the workplace there may be factors such as:

• Feeling undervalued by other team members
• Inadequate training
• Lack of job satisfaction
• Inadequate staffing levels and/or skill mix
• Threat of unemployment/redundancy
• Conflict
• Inadequate management systems
 • Inadequate communication within the workplace
• Long working hours and demanding shift patterns
• Inexperience
• Excessive workload
Demands may be internal, coming from the person themselves and may include:
• The person’s own personality – perfectionist who makes excessive demands
on themselves.
• Self-critical
• High expectations of self and others
• Unachievable or unrealistic goal setting
• Guilt feelings either reasonable or unreasonable.

9.3 Ways to manage stress

One of the first steps is to recognise that you are experiencing stress symptoms, and
then to try and organise a manageable way of dealing with the demands in your life.
We need to accept that we cannot control everything in our lives. Getting a balance is
important; knowing what stressful situations we can change and accepting those we
cannot.

Internal demands:

• You can start by being less demanding of yourself if your life is busy and
causing feelings of stress.
• Set reasonable time scales to complete all the things you want to do. Are there
any things that can reasonably be put off for a day or two? Which things are
most important?
• There may be situations where stress is ongoing, but it may help for you to
reduce stress in another area of your life. This might be through listening to
some music, enjoying the company of friends or family, or just a relaxing bath
and an early night at the end of a hard day.
• Take some time for yourself to redress the balance.
• Don’t feel guilty for taking some time off to manage the demands effectively.

External demands:
This is any stress that comes to us from someone or somewhere else, such as needs
of family or work demands. Not all demands made of you will be reasonable.
• Consider ways that you may be able to address the demands that are placed
upon you.
• Learn to say ‘no’ when you feel too much is being expected of you.
• Don’t feel guilty for refusing requests from others sometimes.

This will help you to continue to manage everyday demands more effectively in the
long run.
Getting Help
• Communicate your feelings and concerns to your manager. They have a
responsibility to support you and assist you to access additional support if this
is necessary.
• Many people seek advice from their General Practitioner (GP) who will probably
ask you some questions about your general health and offer health advice and
may prescribe a short course of medication. Physical tests may be carried out
(such as blood pressure checks) to rule out other health problems. Your GP
may refer you/or advise you to speak to a counsellor.
• Family and friends can be supportive in your efforts to manage your stress, by
learning to be reasonable with their demands on your time. You will also need
to make your needs known, and if you feel unable to manage a request then
say so.

Learning outcome 10

The learner will:

Understand the procedures regarding handling medication.
The learner can:
10.1 Describe the main point of agreed procedures about handling medication.
10.2 Identify who is responsible for medication in a social care setting.
10.3 Explain why medication must only be handled following specialist training.

10.1 The main points of agreed procedures about handling medication

Medicines and COSHH

Some medicines may cause a hazard to staff if they are not administered stored or
handled in the appropriate manner. It is therefore essential to know how the Control
of Substances Hazardous to Health (COSHH) Regulations 2002 relates to medication
in order that precautions can be taken to minimise any risks or harm from occurring.
All medicines should be recorded on receipt, administration, and disposal.

Ordering and receiving of medicines

Care Homes may have different mechanisms for obtaining supplies of medicines;
these will be identified and explained in your organisation’s policies and procedures.
The supply of Medicines to Care Homes is governed by the Medicines Act 1968. This
Act categorises medicines into three groups.
• General Sales List (GSL) – Medicines, which can be purchased from any shop.
• Pharmacy Only (PO) - may be purchased from a pharmacy.
• Prescription Only Medicines (POM) - Medicines that can only be obtained with
a prescription.
Supply

The supply of all medication to all care organisations within the United Kingdom is
governed by the Medicines Act 1968. Your organisational policy relating to the supply
of medicines will have been written in line with this piece of legislation, and should
clearly indicate the following information:
• Details of the supplying pharmacy and contact name of the pharmacist in
charge.
• Details of arrangements for regular supplies of routine prescriptions, including
ordering and receiving.
• Details of how to obtain medicines out-of-hours.
• Details of emergency supply procedures

Individuals who are cared for in their own homes are generally responsible for
receiving, storing and administering their own medication. They may receive
medication by collecting it themselves from the pharmacy or the medicines being
delivered to their home. Alternatively, a relative or friend may collect their medicine for
them. Any care worker working in an individual’s home who, as part of their role,
collects medicines from the pharmacy should be clear about their and the care
organisation’s responsibilities.
All Medicines arriving at the care home, either from the individual’s home, pharmacy,
or other health care setting, must be fully documented. The records must clearly state
the following:
• The date of receipt.
• The name and strength of the medication.
• The quantity received.
• The individual for whom the medication is prescribed.
• The signature of the care worker receiving the drug.

These records must be kept available for inspection and stored for 8 years.

Verbal Orders
Verbal orders really should be avoided wherever possible, but occasionally prescribing
officers may give verbal instructions to care homes regarding changes in prescription,
for example to increase the dose of a medication that an individual is already taking.
Where a verbal order such as this has been given by the prescribing officer, written
confirmation of the change must be requested, and that confirmation should be given
by email as quickly as possible. It is essential that all verbal orders are documented in
order to protect individuals and care staff and to provide evidence for verification at a
later date. This should be covered in your organisational policy.
Storage of Medicines

Some of the main pieces of legislation relating to the storage

of medication includes the following:
• The Misuse of Drugs Act 1971
• The Medicines Act 1968
• Health and Safety at Work Act 1974
• The Control of Substances Hazardous to Health
Regulations 2002
• Hazardous Waste Regulations 2005

However, your organisation should have policies and procedures relating to the Safe
Storage of Medicines, and it should have taken all the legislation and guidelines into
account. It is the Registered Persons responsibility to ensure that there is a policy
covering the storage of medicines and it is your responsibility to access that policy and
comply with it.

General Considerations

The care organisation must have designated secure and temperature-controlled areas
to store medicines. There must also be space to store nutritional supplements,
prescribed dressings, and ostomy products, complying with the manufacturer’s storage
advice. No medicinal item should be stored on the floor.
These areas should be locked rooms preferably without external access via windows.
If it is not practicable then the window should be secured with bars or other securing
devices. The store should never have access via an external door.
If this is not practicable to have a secure room to store medicines, then a secure
cupboard can be used. This should be of a size suitable for storing all medicinal items
needed. This cupboard should be used to store medicinal items only and nothing else.
It is not acceptable practice for items such as money and jewellery to be kept in a
medicine’s storage area. It must be fitted with a quality lock and access restricted to
authorised persons only.

Mobile Storage

If a trolley is used to store medicines it should have the capacity to lock away all
medicines, including those not currently in use for that medicine round. It must be
locked and secured to a wall when not in use. This area should not be accessible or
readily visible. Ideally, the trolley should be secured in a locked, suitably designated
room. Lockable trolleys or lockable secure containers should be used when conveying
medicines to individuals situated in other areas of the care environment. All mobile
storage containers must be always under the observation of the designated person
when administering medicines and must be locked and secured to a wall by an
approved device, and preferably locked out of sight when not in use.
The keys and access to all areas and containers for the storage of medicines must be
always kept safely with the designated responsible person. Access to these areas
should be restricted to authorised personnel only.
Careful consideration should be given to how the medicines have been dispensed e.g.,
monitored dosage system (MDS). Adequate storage must be always provided,
including storing of medication that needs returning.
The temperature for medicines without special storage instructions should be stored
in temperatures of between 16 and 25 degrees centigrade and out of direct sunlight.

Cold Storage

Some medicines need to be stored in a refrigerator to prevent them from deteriorating.

The recommended storage temperature will be indicated on the packaging or a label
applied by the dispensing pharmacist. If these medicines are not stored at the correct
temperature, they may develop harmful bacteria, become ineffective or may go out of
date more quickly, all of which may result in harm to the individual.
A separate lockable refrigerator should be used for storing these medicines and should
not be used for storing any other items. The temperature should be monitored daily
and recorded using a minimum/ maximum thermometer. The normal range for the
temperature should be minimum 2 degrees centigrade and maximum 8 degrees
centigrade. Always report if temperatures are outside of this range.
Medicine must only ever be administered in conjunction with a written prescription
unless the prescribing practitioner administers it personally. The only exception would
be the areas where agreed 'homely remedies' have been agreed; this exception will
be covered in detail in your organisational policy.
Remember:
Medicines should be kept in their original bottles, containers, or blister pack
systems in which they were dispensed by the pharmacy until the actual time of
administration. Immediately after administration bottles and containers should be
returned to safe storage.

Information on a medicines action, side effects and how to administer the medicine
should be provided by the doctor or pharmacist.

Storage of Controlled Drugs

Unless individuals are self-medicating, Controlled Drugs must be stored in cupboards

which meet the requirements set out in the Misuse of Drugs Act 1971. These
regulations specify the quality, construction method of fixing and the lockage of
Controlled Drug cupboards.
Controlled Drug cupboards are locked metal cupboards, which are securely wall
mounted. These cupboards must be rag bolted to an internal wall.
Only staff with authorised access are permitted to hold the Controlled Drug cupboard
keys, this means you should never give the keys to a member of staff who is not
permitted access to Controlled Drugs.
You must only store Controlled Drugs in the Controlled Drug cupboard; items of value
such as money/jewellery or other non-controlled drugs should not be stored in the
Controlled Drug cupboard.
For individuals who self-administer their own Controlled Drugs, they should be stored
in their own individual lockable cupboard, to which the individual has his/her own key.
Controlled Drugs should only be taken out of the Controlled Drug cupboard whilst they
are being dispensed or counted for stock control purposes. This should be witnessed
by 2 staff members.

Administration of medicines

In line with adhering to guidelines on accountability and in the best interests of

individuals, it is important that you:

• Know what the medicines you are administering are used for, including normal
dosage, side effects, precautions, and contra indications.
• Be certain of the identity of the individual to whom you are administering the
medication.
• Be aware of the individual’s care plan and any allergies that he or she may
have.
• Check that the prescription or the label on the medicines are clearly written and
all information is correct.
• Check the expiry date of the medicine to be administered.
• Contact the prescriber, without delay, where contra indications to the prescribed
medication are discovered or if the individual refuses to take their medication.
• Medicine should never be dispensed and given to another care worker, to
administer to the individual later.

Guidelines for Administration

Before you begin administering medicines you must wash your hands thoroughly. The
medicine trolley must be prepared with all the items you will need.
You will need to ensure that you have collected the MAR sheets, any medicines from
the drugs fridge, have a sufficient supply of clean graduated medicine pots, medicine
spoons, water, glasses, drinking straws, tissues or paper towels, disposable gloves for
applying creams. You will also need a suitable container for the collection of used
equipment. You may require an oral syringe for the measurement of small amounts of
liquid medicines, if so, ensure you have them with you.
To establish the individual’s identity, you can ask personal details such as name and
date of birth where appropriate, to check against the MAR sheet and name band if
worn. It is also accepted as good practice to use a current photograph of the individual.
The correct medicine should be chosen, remembering the FIVE R’s.
• Right medicine
• Right individual
• Right dose
• Right time
• Right route
Administration of controlled drugs

The administration of Controlled Drugs will be covered by organisational and local

policies. The following must be included in the safe administration of Controlled Drugs.

• The designated worker takes the Controlled Drug from the Controlled Drug
cupboard and check against the MAR sheet, at the same time the stock amount
of the Controlled Drug must be checked with the Controlled Drug Register.
Another designated worker must check this process at the same time.
• The two designated workers then check the Controlled Drug and its dosage at
the same time.
• The remaining stock of Controlled Drug is then returned to the Controlled Drug
cupboard, which is securely locked.
• The two designated workers will administer the Controlled Drug to the individual
using the usual administration process.
• The Controlled Drug Register is then completed, as policy and the remaining
stock balance documented.
• Stock balances will be checked at each administration and also on a regular
basis as defined by organisational and local policies.

Disposal of medicines

All surplus, unwanted, contaminated, discontinued or those medicines past their expiry
date must be disposed of in an appropriate manner.

Care Homes (personal care only)

According to the Hazardous Waste Regulations (2005) any surplus medication within
a care home that offers only personal care is classed as household waste. This means
that if a medicine is no longer required or has passed its expiry date, it can be returned
to the homes contracted pharmacist for disposal.

Care Homes (nursing)

Any medication that is no longer needed within a care home that provides nursing care
is classed as industrial waste under the Hazardous Waste Regulations (2005) and so
is subject to the Special Waste Regulations (1996). Any person who has a
responsibility for destroying industrial waste must hold a license which can be obtained
from the Environmental agency. This means that if medication is no longer required or
has passed its expiry date, it will need to be disposed of through a licensed waste
disposal company. Some pharmacists may hold a Waste Management Licence and
can also be used for the safe disposal of medication.
All medicines prescribed and dispensed for a person are the property of that individual.
Medicines should be given to the individual unless they give consent for their disposal.
It is the responsibility of the staff within the care home to ensure that a complete record
of medicines going out of the home is recorded. This record must be kept safe for
eight years.
This record must be able to provide a full audit trail (an audit is a review, inspection or
check of what happens by whom, where and when). This record must include:

• Date of disposal/return to pharmacy/disposal company.

• Name and strength of medicine.
• Quantity removed.
• The name of the individual for whom medicine was prescribed or purchased.
• Signature of the member of staff who arranges the safe return of the medicines
to the pharmacist.

Disposal of controlled drugs

In accordance with The Misuse of Drugs Act 1971 controlled drugs within care homes
without nursing should be returned to a community pharmacy. Care homes with
nursing should denature the controlled drugs before handing to the waste disposal
company. It is recommended that two staff members are involved – one to denature
and one to witness.

Other arrangements

To dispose of needles, you will need a sharps box and a liquid waste bin for the
disposal of liquid medicines and syrups. These will be collected by a company that has
a license to do so.

10.2 Individuals responsible for medication in a social care setting

The role of the General Practitioner (GP)

In relation to handling medication the GP would be responsible for the clinical

assessment of the individuals, establishing a diagnosis and clinically managing the
individuals’ condition. This will include the prescribing of medication and the review of
pre-existing medications.

The role of the prescriber/GP

A prescription can be defined as a written instruction to a pharmacist, by an authorised

prescribing officer to dispense medication to a particular person.
Prescriptions may be handwritten, or computer generated but must always be
completed in indelible ink. This is to ensure that the prescription cannot be altered in
any way. If an alteration needs to be made to a prescription it must be fully re-written
by the prescribing officer.
People who are authorised to write a prescription include doctors, dentists, some
registered nurses who have undertaken extended training in prescribing and some
registered pharmacists who have met the requirements to become independent
prescribers.
Prescriptions requested for continuous treatment are usually written for 28 days or
multiples of.
All prescriptions must contain the following information:

• The date that the prescription was written.

• The name of the medicine that has been prescribed.
• The dose of the medication and how many times per day it must be taken.
• The route by which the medication must be taken.
• The formulation of the medication, e.g., liquid, tablet etc
• The individual’s full name and address.
• The individual’s date of birth.
• Signature of the prescriber.
• Contact details of the prescriber including their name, address and telephone
number.

If any of this information is missing the prescription will not be regarded as valid and
the pharmacist will not be authorised to dispense the medication. In these
circumstances the pharmacist will either contact the prescribing officer or the
prescription will need to be re written.
It is recommended that all individuals over the age of 75 years should have their
medications reviewed every twelve months at least. Those taking four or more
medicines should be reviewed every six months.
The prescription is the only document that is signed by the prescriber and in order to
ensure a complete audit trail is recommended that the care home keeps a record of
prescriptions issued and dispensed for each individual. It is considered good practice
to photocopy prescriptions.

Role of the Pharmacist

The law requires that the pharmacist can supply prescription only medications only in
accordance with a valid prescription.
The role of the pharmacist however is more
complex than simply dispensing medication.
Pharmacists also have a responsibility to ensure
that processes are in place so that medicines are
prescribed, supplied, stored, prepared,
administered and disposed of correctly.
Pharmacists also have a central role in an
inspection and advisory capacity. As part of
annual inspection visits, a pharmacist will review all your organisation’s policies and
procedures in respect of handling medication.
Pharmacists' prime concern, irrespective of their sphere of work, must be for the
wellbeing and safety of individual and the public, and it is the responsibility of the
pharmacist to inspect your care home’s records regarding medication. This will include
looking very closely at documents such as:

• Medication policies and procedures.

 • Records for ordering medication.
• Records for the receipt of medication.
• MAR sheets.
• Medications that have been transferred into and out of the home.
• Records of medications which have been returned to pharmacy for disposal.

The pharmacist will also check:

• Medication storage systems.

• Methods of drug administration.
• Service users who self-administer their medication.

Pharmacists have the responsibility of making recommendations on any aspect of

handling medication should problems be evident. The pharmacist will then be
responsible for ensuring that recommendations are followed up within a specified
period.

Role of the care home manager

The registered person/care home manager must ensure that there are policies in place
for the receipt, recording, storage, handling, administration, and disposal of medicines.
They must also ensure that all staff adhere to the procedures laid out in these policies.
The purpose of these policies is to promote the safety and well-being of the individual
and to enhance safe practices within the care home. If the care home manager
chooses to appoint a designated person to look after the medicines, then the
designated person and any members of staff should be appropriately trained and
assessed as competent to undertake this role.
It is essential that policies and procedures are in line with current legislation and to
comply with this, it is essential that the care home manager is up to date with current
legislation and the standards required for the safe running of the home.
The registered person is legally responsible for ensuring that records are maintained
and that they are properly completed, clear and legible and current. These records
should provide a complete audit trail right through from receiving the prescription to
disposal of medications.
The manager or the designated person within the home should be the one to initiate
the order for prescriptions. This is the only document that is signed by the prescriber
and it is good practice to take a copy of this document for future reference.

Role of the designated person in administering medication

Whatever medication is being administered; all care staff have a duty of care that
requires medication to be handled safely. It is essential that any staff involved in the
administration of medication have been appropriately trained and assessed to do so
and that policies are always adhered to.
The person who is administering also has a legal duty to acknowledge his or her own
limitations and should take personal responsibility for maintaining and updating their
knowledge and practice in relation to handling and administering medication. This
should be within the guidelines of the Skills for Care Code of Conduct for adult social
care workers.
Standard 6.2 participate in continuing professional development to achieve the
competence required for your role.
The authorisation to administer a medicine is the signed prescription of the authorising
prescriber; the designated person is also authorised to administer medication through
the manager, in accordance with the prescriber’s instructions. The administration of
medicine also requires the authorisation of the individual, in the form of consent.

The care workers role in handling medication

The handling and administration of medication is an extremely important aspect of your
role, it is also one that should be approached with extreme care and caution and should
never be undertaken lightly. It is not just a physical task that is carried out in strict
compliance with a written prescription or on the instruction of a medical practitioner. It
requires careful and professional thought and judgement to be applied.
The basic principles that underpin the safe handling of medication within any
establishment are the same whatever the nature of the care that is offered and whether
staff have a nursing qualification or not. All care staff have a duty of care that requires
medication to be handled safely. Any handling of medication can have the potential to
produce harmful reactions with possible fatal consequences.
It is important that your role within your workplace is very clearly defined and that
appropriate training and continuing professional development are made available to
you in order that you can undertake your daily duties.

10.3 Why medication must only be handled following specialist training

Appropriate training

Any training that you undertake must be accredited, and must include:
• Basic knowledge of how medicines are used and how to recognise and deal
with problems in use.
• The principles behind all aspects of the home’s policy on medicines handling
and records.

The Skills for Care Code of Conduct states that as an adult social care worker you
must:
6.3 “carry out competence-based training and education in line with your agreed ways
of working”.
Reflecting on your role and identifying exactly what your responsibilities are within that
role can help you to assess your learning and developmental needs. It can also help
you to identify future needs.
Continuing professional development

Requirements for the safe and secure handling of medicines may change from time to
time. It is therefore essential that all practitioners keep themselves up to date with
current practice guidelines. Continuing professional development is an essential
element in improving the quality of the service provided.

Health care professionals have a duty to keep their practice, knowledge, and skills up
to date, and the public have a right to expect this.
Your employer should also encourage you to develop yourself within your working
environment and should support you in your role by providing adequate induction,
training, and development opportunities.
All staff involved with medicines have a duty to ensure safe and secure handling of
medicines through compliance with relevant legislation and national and local policies.
It is imperative that you are aware of this and always apply these requirements.

Learning outcome 11

The learner will:

Understand how to handle and store food safely.
The learner can:
11.1 Identify food standards relevant to social care settings.
11.2 Explain how to:
• Store food
• Maximise hygiene when handling food.
• Dispose of food.
11.3 Identify common hazards when handling and storing food.

11.1 Identify food standards relevant to social care settings

Legislation
Laws have been put in place to protect people from eating contaminated food which
might cause them harm. The main piece of law on this subject is the Food Safety Act
1990.
This allows Environmental Health Officers (EHOs) enforcing these laws to:
• Enter food premises at any reasonable time.
• Close food premises if they are a serious health hazard.
• Instruct businesses to make improvements if defects are found.
• Inspect documents e.g., cleaning schedules, temperature records.
• Take food samples for laboratory testing.
• Prevent selling of suspected food.
• Remove foodstuffs unfit for human consumption.
The Care Quality Commission (CQC) requires all care services to handle, store,
prepare and deliver food in accordance with the requirements of the act.

Food Safety (Temperature Control) Regulations 1995

In general, these regulations state that high-risk foods must either be kept below 8 oC
or above 63oC, known as the Danger Zone. Some foods must be kept even colder
(there are a few specific exceptions). Although the law states 8° C - 63° C, many
businesses in the food industry work on a range of 5° C - 63° C. Operationally this is
viewed as best practice.

Food Safety (General Food Hygiene) Regulations 1995

This requires hygienic construction of food premises including adequate toilet and
hand washing facilities, and protection from pests.

Food hygiene

In many health care environments, there may be infection control responsibilities under
the Food Safety Act 1990 and the Food Safety Act (General Food Hygiene)
Regulations 1995.

Under this legislation, workers who handle food must:

• Keep themselves and their workplace clean.

• Wear suitable clean, washable, or disposable,
protective clothing.

Protect food from any possible contamination

• Abide by regulations setting out safe temperature controls for storage,

preparation, and display of food.
• Inform their employer of any illness which may affect their safe handling of food.

N.B. These regulations also require that employees who handle food as part of their
normal duties should also undertake specific food hygiene training.

Hazard Analysis

The law states that every food business:

• Must look at the steps involved in storing, preparing, displaying, and selling
food.
• Identify what hazards could happen at each step.
• Identify the steps critical to food safety (these are sometimes called Critical
Control Points)
• Control the hazards at these critical steps and monitor to ensure this is being
done.
• Review their hazard analysis periodically.
In most businesses, there is no statutory requirement to keep records, but they are
helpful in proving that you are trying to do things properly.

The Food Safety (General Food Hygiene) Regulations (1995) deal with the safe
preparation of food for human consumption.

It is concerned with:

Food premises and storage

Food handlers
Food safety assessments
Training

Everyone involved in any aspect of food preparation or handling must

undergo training.

11.2 Explain how to store food, hygienically handle food and dispose of food

Food Storage

There is a huge variety of food products available today, each having their own special
storage requirements to keep them in good condition. Therefore, it is important to
handle and store food in the best possible way – in the right conditions, at the correct
temperature and for a safe length of time.

Deliveries

Most organisations which handle food have guidelines for checking food deliveries, but
the key points are to ensure that food is fresh, at the correct temperature and contained
in clean undamaged packaging.

Dry Storage

Dry storage is the long and short-term storage of canned and bottled goods, cereals,
grains, tea, coffee and spices. These must be stored in cool, dry, well ventilated
conditions, off the ground, with enough space left between to allow for a flow of fresh
air. When storing or displaying food the stock with the shortest shelf life should be
placed at the front. This makes stock rotation much easier as stock with the shortest
shelf life will be used first. Always check the date mark, packaging, and condition of
food before use.

Refrigerated Storage

High risk and perishable foods must be kept in a fridge because this reduces the risk
of fast reproduction of pathogenic or spoilage bacteria. If possible, use separate fridges
for raw foods such as meat and poultry and for high-risk foods as discussed previously.
Where a fridge is multipurpose, always store raw meat and poultry on the bottom shelf
so that blood and juices do not contaminate foods below. Stack shelves to allow for a
good circulation of air and ensure that the fridge handle is cleaned and
disinfected regularly. Keep doors closed and try to arrange your work so as not to
constantly open and close the door as this allows temperature to rise.
Refrigerated temperatures should be kept 0 oC – 5oC and checked regularly.

Freezer Storage

Although bacteria are usually dormant at temperatures of –18oC or below, they often
survive freezing and will start to reproduce as soon as food reaches the danger zone.
As with fridges, separate freezers should be used when possible, for raw foods and
high-risk foods. Where this is not possible raw foods must be stacked below high-risk
foods. Those with a short shelf life should be easy to access as in dry storage stacking.
Always make sure that all food is labelled and easy to read.
Freezer temperatures should be kept to below –18oC and checked regularly.

Maximising hygiene when handling food

What is Food Hygiene?

We all need to eat and drink to stay alive, so it is important that this food does not
harm us in any way. Food hygiene incorporates the measures and good practices
needed to ensure that food is safe, wholesome and fit to eat. While high standards
enable everyone to enjoy their food without illness, injury or other problems, poor
standards can lead to all kinds of harm – even death! As food handlers we have legal
obligations for keeping food safe to eat.

Symptoms of food poisoning:

• Vomiting - being sick.

• Diarrhoea
• Nausea - feeling sick.
• Abdominal pain
• Fever – a raised temperature.
• Headache – with some types.

Hand washing

Hand washing is an essential part of good food hygiene and should be carried out
frequently and effectively throughout the working day. Hands, especially under and
around the nails, can harbour dirt and bacteria which can cross-contaminate foods
handled. However, there are regulations laid down that state when hands must be
washed:

Before:

• Starting work
• Touching raw or high-risk foods.

Between:

• Handling raw and cooked foods.

After:

• Handling raw foods.

• Visiting the toilet.
• Handling raw eggs in their shells.
• Coughing or sneezing into hand or handkerchief.
• Touching hair or face.
• Cleaning or contact with chemicals.
• Dealing with waste or rubbish.
• Eating, drinking, or smoking.
• Touching animals.

How to Wash Your Hands

Duration of washing is important, not only for mechanical action but also to allow
microbial products sufficient contact time. Therefore, it is recommended that hands are
rubbed vigorously together, generating friction on all surfaces of the hand and fingers.

Reporting illness

It is the responsibility of the food handler to inform their employer if they have or have
had certain illnesses, because there is a legal requirement to report:

• Diarrhoea
• Vomiting
• Nausea
• Eye, ear, or nasal discharge
• Septic cuts, open wounds, broken skin, or any other skin infection
• Food poisoning or food-borne illness of close family or friends.

Your employer will advise you what to do. If visiting a doctor, you must inform him/her
that you are a food handler.

Cleaning

Cleaning is the process of making something free from dirt and contamination. The
purpose of cleaning is to:
• Remove conditions conducive to the growth of bacteria.
• Reduce the numbers of active bacteria remaining.
• Minimise cross contamination from one surface to another.
• Prevent damage to equipment.
• Satisfy legal and moral requirements.
• Provide a safe and pleasant environment by removing slippery grease, oil and
liquids.
• Reduce the risk of attracting pests.
• Create a clean and hygienic picture for customers.
• Prevent offensive odour.
Detergents

Are cleaning chemicals, which will help to dissolve dirt and grease, however they do
not kill bacteria even though surfaces may look clean.
Detergents are needed to dissolve grease, fat, and dirt in water so that it can be easily
removed.

Disinfecting

Will reduce the number of bacteria to a safe level but it will not get rid of all bacteria.

This is achieved using:

• Extremely hot water above 82oC.

• Steam
• Chemical disinfectant.

Disinfectants must be used after cleaning, as they cannot remove dirt and grease.
Manufactures instructions should be followed carefully. However, it is possible to use
a sanitiser which combines cleaning and disinfecting providing manufacturer’s
instructions are followed.
There is a wide range of chemicals available, and a full knowledge of the product is
essential as mixing certain chemicals release harmful gases.

Areas to disinfect/sanitise

Food contact surfaces, including:

• Chopping boards, preparation surfaces.

• Food processing machinery such as slicers, mixers, mincers, knives, tongs and
other utensils.
• Containers.
• Production belts.

Hand contact surfaces including:

• Handles – doors, fridges, freezers, cupboards, drawers.

• Taps.
• Switches.

Contamination high-risk areas

• Mops and floor cloths.

• Dish cloths and cleaning cloths.
• Waste bins and their lids.
Disposing of food

Household waste including food must be collected regularly in (usually black plastic
bags) which should be tied securely and removed by the local authority, bag colours
may change dependent on the local authority. This waste is taken to the local landfill
as it is a low-risk source of infection.

There may be arrangements in your area for food waste to be recycled. Local authority
and care organisation policies will provide guidance to which you should adhere.

Kitchen waste is a breeding ground for bacteria so the sooner the waste is disposed
of the better.
Food waste and other rubbish can be a source of physical and bacterial contamination
and can attract pests if it is not disposed of properly. There should be separate bins
for inside and outside use. Bins used inside should be within reach, but not so close
to food as to pose a risk of contamination. The bin should be lined with a disposable
plastic sack and have a well-fitting lid to prevent insects gaining access. A foot-
operated bin seems to be most effective. As each bag becomes full it should be tied
and taken to external bins. It should not be left to overflow or left in the food preparation
area as it will encourage pests.

11.3 Identify common hazards when handling and storing food

Food contamination can take three forms:

1. Chemical contamination can occur through pesticides, cleaning materials and

grease or fumes. It often arises because of poor storage of chemicals and cleaning
materials or inadequate rinsing after cleaning.
2. Physical contamination happens when foreign objects get into exposed or open
food. Physical contamination can include:
• Nuts, bolts, and washers etc. from machinery
• Shards of metal from can openers
• Shards of glass from bottles and jars
• Insects
• Packaging materials
• Flaking paint
3. Bacterial contamination can arise from sources including:
• People: from nose and mouth, hair and dandruff, spots, boils, cuts, faeces,
urine, clothing, poor personal habits, and inadequate hand washing
• Raw Food: which may allow bacterial contamination to cooked food
• Dirty food preparation areas, utensils, and equipment
• Food Pests: insects, rodents, and birds
• Domestic pets: cats and dog carrying bacterial infections.
• Waste and Refuse: rubbish, leftover food and dirty kitchen tools which attract
flies and rodents if left unwashed or uncovered.
Other hazards may include:
 • Out of date food
• Dented or rusted canned foods
• Incorrect temperatures of fridges or freezers (keeping food in danger zone
temperatures of 5- 63 degrees c
• Storing raw and cooked foods together
• Not using disposable gloves
• Storing food outside safe temperatures
• Cooling hot food too slowly (must be cooled to 5 degrees c within 90 mins)
Regardless of the circumstances in which food is prepared, displayed, served, and
stored, it must remain safe, appetising and nutritious to eat. All food handlers are
morally and legally responsible for keeping food safe, so it is important to know the
general principles for food safety, be able to identify hazards and follow the rules of
your workplace.

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now visit [Link] using the login details provided at

the start of the course and then download, complete and upload the activities,
workplace tasks and reflective journal from the online learning platform before
proceeding onto the next unit.
Unit 9 Understand How to Handle Information in Social Care
Settings Y/602/3118

Unit purpose and aim

This unit introduces the knowledge required for good practice in recording, storing, and
sharing information in a social care setting. This unit is aimed at those who are
interested in, or new to, working in social care settings.

Learning outcome 1
The learner will:
Understand the need for secure handling of information in social care settings.
The learner can:
1.1 Identify the legislation that relates to the recording, storage and sharing of
information in social care.
1.2 Explain why it is important to have secure systems for recording and storing
information in a social care setting.

1.1 Legislation that relates to the recording, storage, and sharing of

information in social care

Legislation
The Information Commissioner’s Office (ICO) oversees all legislation relating to
information. The legislation is in place to protect the rights of individuals using services.
It ensures that information is held only with consent, kept securely, shared only on a
need-to-know basis and is accessible to individual.
Legislation governs what records care services are required to keep, and the
standards to which they must adhere.

• Data Protection Act 2018

• General Data Protection Regulations 2018
• Access to Records Act 1998
• Freedom of information act 2000

The Data Protection Act 2018

The DPA 2018 sets out the framework for data protection law in the UK. It has replaced
the Data Protection Act 1998 and it sits alongside the GDPR and outlines how the
GDPR applies in the UK. The DPA consists of these elements:
• General data processing
• Law enforcement processing
• Intelligence services processing
• Regulation and enforcement.
The General Data Protection Regulation (GDPR)

These regulations are European-wide and replaced the Data Protection Act 1998.
Even though the UK is no longer a member of the EU, many of principles still apply in
the UK. It explains how organisations must handle personal data. It has 7 key
principles:

1. Lawfulness, fairness and transparency

2. Purpose limitation
3. Data minimisation
4. Accuracy
5. Storage Limitation
6. Integrity and confidentiality
7. Accountability

These regulations offer good advice for the handling of information. For example,
records held in a file, should be stored in a locked cabinet, with access restricted to
those who have a right to access these records. Information stored on a computer or
a device must be password protected. Each member of the care team should know
what records they are entitled to access, and those to which they are not. You should
know where records are stored and be familiar with retrieval and filing procedures.
Records should never be left unattended; you must return a file once you have finished
with it.

Access to Records Act 1990

It is important that you are aware, not just in your role as a care worker, but as an
individual, that people have a right in law to access their own records.

The individual access to records

The content of the individual’s medical notes is not usually read by the individual,
although the individual has a legal right to request access to these under the Access
to Health Records Act. There are a few exceptions:

• Health service records completed before 1991- although individuals are

usually allowed to see these
• Individual’s records which include confidential information about another
person/s - although they still have the right to see records about
themselves
• When a doctor considers that medical records would cause so much
distress that the individual’s health would be damaged

Many care organisations encourage the sharing of nursing records such as care plans
and charts with individuals. This helps individuals to understand the care and treatment
they receive and enables them to feel more involved in their care.

Although individuals rarely ask to see their records, it is important to remember that
they have a right to. You should ensure that you report any requests by individuals to
access their records, to your manager who can facilitate this.
Certain staff have access to certain records. This will be dependent on legislation and
organisation policy.

Freedom of Information Act 2000

An act to make provision for the disclosure of information held by public authorities or
by person providing information for them.

1.2 The importance of having secure systems for recording and storing
information in a social care setting

Confidential information

As a health care worker, you are in an extremely privileged position, as, during your
work, you will receive some very personal or highly sensitive information about people.
Whether to share this and who with can be quite difficult at times, so it is important that
you know what confidentiality means and understand how it affects your practice.
The Skills for Care Code of Conduct states that adult social care workers must.

Standards 5. “Respect a person’s right to confidentiality”.

The importance of maintaining individual confidentiality throughout any form of

communication cannot be overstated. Breaches of confidentiality can have serious
consequence for the individual, who may lose trust in the care worker. The care worker
may face disciplinary action by the employer if guidelines are breached.

Your contract of employment means you have a responsibility to your employer and
individuals to maintain confidentiality. If you disclose information, you may find
yourself subject to disciplinary action. This also applies to the storage and recording of
confidential information.

Computer records

An individual’s personal banking details and financial

information can be held as a computer record and to protect
identity theft access would be limited to restricted personnel
only and with the additional protection of passwords.

Legal documents

It is vital that when you make a written entry about an individual, your notes are
complete, accurate and legible; to avoid errors and mistakes which may affect the
standard of care the individual receives. Written entries should always be recorded in
a way that respects the confidentiality of the individual and should never be shown to,
or shared with, those who do have a right to access. Precautions should be taken to
ensure recordings are made in a private area where information cannot be seen.
Written communication

Verbal communication cannot be relied upon, as information can be misunderstood or

forgotten. Information about individuals must be written down.
Access to certain records, such as medical notes should be restricted to trained staff
and management, including those who deal directly with doctors, and are accountable.
These records should be stored in a locked cabinet or cupboard.

Entries

It is essential that entries into records are accurate, complete, and legible. This will
ensure that all records are reliable and fulfill their function and purpose.

There are several rules that should be followed, such as:

• Use appropriate and respectful language.

• Present information in an objective manner. You must always ensure
that the information you record is not based on biased judgements or
opinions.
• Use factual information.
• Be aware of who has access to what you record. This may include the
individual.
• That the correct level and amount of information is recorded. All details
should be recorded concisely, but with no omissions.

Recording Information

Information must always be recorded. This ensures that:

• The information is available to all who have a right to access it

• Progress is monitored
• The needs and interests of individuals can be met more fully
• Changes are recognised immediately
• Information is not forgotten
• Mistakes and omissions are less likely
• The information will be stored securely, and confidentiality maintained

Storage of Confidential information

Records held in a file, should be stored in a locked cabinet, with access restricted to
those who have a right to access these records. Records that are in use should be
stored securely, in accordance with legislation and organisational policy. Each
member of the care team should know what records they are entitled to access, and
those to which they are not. You should know where records are stored and be familiar
with retrieval and filing procedures.
The reasons for making records

Good record keeping is essential to care work. It is important to know and understand
the reasons for, and the purpose of the record. This will mean that you are able to
record information that meets its purpose.

Information may include:

• Problems you had caring for the individual and what you did about this
• Organisation policies which require you to have records you make
countersigned by a senior or trained member of staff
• Omissions in record keeping
• Records which reveal aspects of the individual’s needs are not being
met
• Difficulties accessing or updating records
• Records that are not up to date
• Records are incorrect or altered using correction fluid
• Signs and symptoms observed and/or recorded that indicate there has
been a change in the individual’s condition or care needs, including
changes in communication

A written record will also provide protection for individuals, care staff and others.

Remember:

• The documents containing information about your individuals may be

examined by the registration authority, in a coroner’s court, or in a court
of law
• Any complaints made by the individual or his/her family will be
investigated using verbal and written information. Should a complaint be
upheld, individuals, as well as the care organisation may face disciplinary
or legal action. Alternatively, records can provide protection for the care
team and the care worker, when they clearly prove that there is no cause
for complaint
• You may be responsible for making entries in individuals’ care plans.
This must be done in a way which demonstrates good practice
• Maintaining confidentiality of records is particularly important in relation
to complaints and potential legal action. Records should not be
discussed or viewed by those who are not entitled as this may
contaminate evidence and prejudice decisions. Therefore, the need to
store records securely cannot be over emphasised.

Other agencies

There will be times when staff from other agencies need to examine the records of
individuals. These records will give information which will assist these agencies to
provide services required by individuals. This may be following a needs assessment
or care plan review.
If you have concerns that information is being accessed by people who have no right
to it, or that confidentiality is being breached in other ways, you must report this
immediately to your Manager.

Sharing information

Whilst you may fully understand the concept of confidentiality, deciding whether to
share the information that you receive with others, especially when it is of a serious
nature, can be a difficult decision to make.

Confidential information can be disclosed to an appropriate health care professional if

it is relevant to the care of that individual. It is justified on the basis that the individual
may suffer if that information is withheld, e.g., not passing on the fact that an individual
has an understanding difficulty may result in that individual’s needs not being identified.

Individuals giving information in confidence, have a right to expect that it will only be
used for the purpose for which it was given, and that it will not be shared with others
without their consent. Care staff are not released from this responsibility, even when
an individual dies.

Information care workers are expected to share

You have a duty of care to protect vulnerable individuals from abuse. If an individual
reveals that they are being abused, you must reveal this to your manager to protect
your individual.

If an individual indicates that their health and social well-being is at risk, or that they
are suffering symptoms which may be signs of ill-health (mental or physical), which
are in the plan of care and need to be acted upon, you must report and record this.

Information which directly affects the care organisation, and its effectiveness must be
reported.

These requirements may be identified in documents such as legislation, codes of

conduct, plans of care, policies, and procedures. Individuals must be clearly told by
the care worker that the information they have revealed cannot be kept secret, must
be reported to the manager and the reason why.
Learning outcome 2

The learner will:

Know how to access support for handling information in social care settings

The learner can:

2.1 Describe how to access guidance, information, and advice about handling
information
2.2 Outline the actions to take when there are concerns over the recording, storing,
or sharing of information

2.1 Access guidance information and advice about handling information.

If you are unsure how to handle information you should approach you manager for
support. They will be able to provide you with verbal and written guidance and give
advice about how and where to obtain information regarding handling information in
the care setting.

Organisational policies and procedures

Your organisation will have policies and procedures which govern the way in which
information is recorded, transmitted, stored, and retrieved. These policies will reflect
procedures which have been laid down by legislation. They will also set standards
and give instructions regarding your role in receiving, recording, transmitting, and
storing information. Included will be advice regarding handling telephone enquiries
and guidelines on maintaining confidentiality.

Accessing records

It is important that you are aware of the records you are

entitled to access and handle and you are aware of how
to seek permission from the appropriate people. If you
are unsure, you must seek the advice of your manager.
Further guidance, advice and information could be
obtained from colleagues, the individual themselves or the
internet using search engines of visiting relevant sites
such as the Care Quality Commission’s web site.

Work instructions

Any instructions set by your manager, will conform to the standards set in the policies
and procedures of the organisation. These should clearly explain your responsibilities
and those of your colleagues. If you are responsible for writing in care plans, you
should be aware of exactly what is required. Ideally, there should be written
instructions to support any verbal instructions given to the care team.
Instructions should include the actions you need to take if you have concerns or other
express concerns to you.

2.3 Actions to take when there are concerns over the recording, storing and
sharing of information

Problems with recording information

To identify problems with recording information it is essential that you understand the
correct way to record information and the importance of this.

Written records

All health and social care records are legal documents, and all have the potential to
be read out in a court of law. It is therefore important that written records are of the
highest standard. Records should be:
• Understandable • Complete
• Accurate • Legible
• Made as close to the event • Relevant
described as possible • Respectful of the individual
• Personalised • Clear
• Up to date

In practice this means that you should:

• Write legibly in permanent ink, preferably black
• Date and sign all entries (if appropriate, include time)
• Avoid meaningless phrases and judgemental statements of a personal
nature
• Do not use correction fluid (when corrections are required, a line should
be made through the incorrect entry, this should be dated, and signed
with your initials)

Any problems maintaining confidentiality whilst recording information must be

reported immediately.

Problems with transmitting information

Knowing when to pass on verbal or recorded information immediately is extremely

important. You should also know who to pass this information to. If you are unsure,
you must discuss this with your manager. There may be policies available to clarify
this. Information should be passed on verbally and a written record made. The
information passed on and recorded, should be accurate and sufficient to allow the
person receiving to have a complete view of the problem encountered. Immediate and
appropriate action can then be taken.
Problems with the storage, retrieval and maintenance of records

You may encounter problems with the storage, retrieval, and maintenance of records.
These problems may include misfiling, lack of space, errors and omissions when
recording and loss or damage to records. Information lost, such as a Medicines
Administrations Record, may affect the quality of care given to the individual therefore
any problems with storage, retrieval and maintenance of information must be reported
immediately to senior staff or your manager.

Access to records and sharing of information

It is important that care workers are not only aware of the records and information they
can access and share, but they are also aware of who is permitted to access particular
records and information. If the care worker is concerned that a person is attempting to
access, or has accessed, records or information, to which they are not entitled, they
must report this immediately. This also relates to computerised records where
passwords may be misused to obtain confidential information, to which the person is
not entitled and which they may misuse.
If a care worker has concerned that information is being shared inappropriately or that
an individual is being pressured to share confidential information, by those who are not
entitled, they must report this immediately to their manager.
Therefore, understanding what to do when there are concerns over the recording,
storing, and sharing of information and the importance of taking appropriate action
cannot be overstated.

Conclusion

The information you have read within this unit, should increase your knowledge and
understanding, which will benefit you, the individuals you care for, key people and
others. Well done on completion of the underpinning knowledge.

Please now complete and upload the activities. Once all modules have been signed
off by your tutor your portfolio will be moderated, following which, we can apply for
certification from the Awarding Organisation.