Sometimes individuals may want to do something which could be a risk to their health and safety. Being a staff member means having a duty of care to that person, it includes doing everything possible to keep them safe, but also having a duty to respect the individuals rights and choice, therefore there is a dilemma. It could be that the individual no longer wishes to use their walking frame, but their care plan states that they need it to move from place to place and as a member of staff, their responsibility is to ensure and encourage the use of the walking frame for the individual. In this scenario a risk assessment could be carried out to ensure that it is managed as safely as possible. The risks would need to be explained that are involved to the individual and make sure they understand. The staff could come to a compromise, to use a stick for a while instead, to see how they managed, then monitor the situation. All this should be documented including any risk assessment carried out.
If the individual still insists on walking unaided they should sign to say they are aware of the risks involved. Another scenario could be that an individual refuses to take their medication. Remind them of why they take the medication and it’s benefits and again advise them of the risks involved in not taking their medication. If they still refuse, ensure this is noted on their medication record and reported so others are aware if a problem occurs. If the individual insists on doing something which is unsafe or risky that is their choice it must be respected as it’s their right, but there is a duty of care to uphold and everything must be done to keep them safe for their individual’s rights. Conflicts could arise between staff to staff. One staff member may think that there is an issue.
An example of this is that a member of staff may think a child is a slow developer, and may need additional support to help them, such as with their communication skills. Another staff member may think that there is no issue the child is just developing at their own pace and that it is normal. Everybody has individual rights, they have rights against the duty of care therefore children and parents have the right to privacy, but it is the staffs duty of care to safeguard, therefore any concerns that may arise about abuse would override their privacy, as the duty of care is much stronger.
This has the dilemma of making parent feel that the staff has taken the duty of care too far, as the duty of care has been overridden their right to privacy, their right still exists to only knows that need to no. It is important that issues are raised in such way that shows concern for a child, and not criticising a parent/carer. If a discussion needs to take place, it needs to be where the staff and parent are alone to remain confidentiality with a clear focus on the child’s best interests.
There are many organisations that are in place to get additional support and advice about conflicts and dilemmas. Learning support is one of these, having learning support in the setting for children with learning difficulties can be a great help, however if the child does not want to seek the help, the staff can only advise them, not force them, however having them in the setting the child would then know they can seek help from them when needed. Speech and behavioural therapists are another additional support for those with speech impairments and behavioural problems, these can come in the help children communicate and feel a part of the setting, and not feel ‘different’ from others around them. The setting can seek advice from child protection, as if there is a worry about a child, the manager can contact them for advice on what to do and if the concern is a serious matter that needs to be taken care of immediately or not.
If a parent/guardian has an issue to raise that involves their child or any aspect within the nursery, they should report this to the manager of their child’s room as soon as the issue occurs. All effort is put it to solve issues that are raised in the setting, complaints can be written or verbal, written complaints are usually replied within three months. There is a framework which the issues will be dealt within. A matter relating to a child may be discussed between the parent and child’s key person or their room manager. If a complaint is remained unsolved, the matter will be raised by the childcare services manager with the appropriate authority and the parent will be kept informed on the progress at each stage of the procedure.
If a parent arrives in the setting with a complaint the practitioner should establish if this is something they can deal with personally. If it is, they can deal with it there and then or make an appointment to see the parent if they are currently otherwise occupied. If it is a matter that needs to be dealt with by a more senior member of staff then the parent can be referred in that direction.
When a complaint arises, the setting should find a way to prevent this from occurring again and find solutions to overcome the situation. When dealing with complaints the staff member should always remain polite and see the parents point of view. They should take responsibility for what has occurred by understanding and taking control of the situation. Notes could be taken down for reminders what complaints have been received before and these documentations be kept in a secure place, the complaints that are made from a parent should be kept confidential regarding if it is to do with their child or the setting itself.