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Putting service users at the heart of provision Essay

Anti-discriminatory practice is promoted in health and social care settings through putting service users at the heart of provision, ‘this means to focus on what the person needs and provide is, giving them control and power over their lives, rather than just telling them what services are available.’ (Health and Social Care, Hodder, Rasheed et al, page 27, 2010) The individual is put at the heart of service provision, the health and social care sector needs to, empower individuals, provide active support consistent with the beliefs, culture and preferences of the individual, promote individuals’ rights, choices and well-being and support individuals to express their needs and preferences.

All care is centred around the individual’s needs. This means that in a health care setting a care plan will be done with the resident so that the resident feels they have control over their care and the staff would be able to care for that service user according the their preferences, sometimes it not possible for the service user themselves to tell the staff their preferences, this could be because of a disability, such as learning difficulties or someone who has a hearing impairment, then the service user could have a family member or an advocate can speak on behalf of them because if the care worker doesn’t do the care plan with them then this will not empower the service user and their care will not be to their preferences which could be very distressing for the resident.

Empowering individuals

Empowerment is one of the fundamental principles of care work, empowerment is about enabling people to take control of their lives through choices and be as independent as possible. It is important in a health and social care setting that they make service users feel like they are still in control, giving them choices about their care, even just little things like where does the individual want to sit, will make them feel more empowered and feel less like their life has been taken control of. In these settings staff members will do care plans with the service users to make them feel involved and like they have control over their care. Even if the care workers don’t totally agree with the service users decisions they can only advise against it and will have to accept and support whatever decision is made by the individual.

Service users will feel more valued when they are being empowered. It is also important that staff allow the service user to be as independent as possible and only helping them where it’s needed so that the individual doesn’t feel like there independence has been taken. A difficulty with this could be if a service user lacks mental capacity, and did not have any immediate family around them, then it would be down to the professionals to make decisions about their care, and would choose the best options for that individual concerning their care, so this would mean that the service user might not feel empowered as they are unable to make their own choices.

Balancing individuals rights with the rights of others

Balancing individual’s rights with the rights of others requires very good organisation, negotiating and communication skills it will also require the support of a network of services with everyone in that service working towards a solution for individual rights. It’s about allowing residents to have a choice, because they have individual rights. an example of this could be if some residents wanted to watch a specific television programme but a couple other residents wanted to watch something else, the staff member would then have to negotiate with the residents and organise a room where the other residents can watch what they wish so that everyone possible is happy with what they are watching.

A problem with this could be if the staff member did not have very good communication skills and was not able to negotiate effectively with the service users, because they have a lack of training in this area, to overcome this difficulty employees need to ensure all staff members have up to date and appropriate training so that the staff member is prepared for everything and knows how to balance individuals rights with the rights of others and how to deal with the conflict.

Culture and preferences of the individual

This means understanding and helping promote the service users culture, religion and preferences, and taking this into account when making decisions in the health and social care setting. An example of this could be if a resident in a care home was a Muslim then the staff members would have to ensure they are able to meet the needs of this faith like that halal meat is available for the resident and there is an area available where the resident can pray if they wish to do so. Also staff members have to support anyone who comes into the service by ensuring they are listened to and receive any support they need with their reading, socialising or personal care and that it is met with sensitivity, some service users may need the support of an advocate if they have communication issues or learning difficulties. The main forms of support may be advice and guidelines, physical support, mental health support, medical and care planning information and social support.

A difficulty with this could be that staff members have not been trained in this area, and do not know about how religions and cultures and what their specific needs are. To overcome this difficulty, staff members should have training in diversity, and learn about other cultures so that they are able to meet the needs of individuals. Another difficulty with this could be that the care home may not have a spare room for residents to pray in, if so then care homes can provide a space in the resident’s room, or clear out a room that isn’t necessarily needed so that a praying area is there, also staff members could take residents out of the care home to a mosque, church, or religious setting of their choice, when it is convenient to do so.

Supporting individuals to express their needs and preferences

This means supporting a service user, who may not be able to communicate effectively, in expressing their needs and preferences so that the service user is happy with the care they are receiving and it meets their likes and dislikes. An example of this could be supporting someone who is deaf, by helping them express their needs and preferences it could mean they would have to use British sign language signers or lip speakers. It is important to keep the individual informed about what is happening to them and what will happen in the future concerning their care, and also services have to make sure the individual can express their needs and preferences. An interpreter can be used for someone who doesn’t speak the local language of the health and social care setting; this could be a professional or could be a family member or friend.

A problem with this could be that if someone who does not speak the local language is a new resident in a care home and has no immediate family, so staff members would struggle to meet the needs and demands of this new service user. To overcome this problem, staff members would have to use an interpreter who spoke both the local language and the resident’s main language. An interpreter can be quite expensive, which is another difficulty the health and social care setting will face, but in some circumstances interpreters are paid for by the NHS, if done privately it can cost a lot of money. Another way to overcome this difficulty if is staff members do small training courses in sign language so they will know the basics for when a service user with a hearing impairment uses that service. If a resident does not speak the local language then a few members of staff could learn the basics in that language so they are able to communicate more effectively with that service user.

Identifying and challenging discrimination

Within health and social care settings it is important that if any discrimination is identified it has to be challenged immediately, this is so the victim of the discrimination does not suffer anymore and this can be achieved by staff training and development, so that staff have an awareness of what to do if they see any discrimination and gives them a sense of awareness on the subject, telling a high authority like a manager when any rules concerning discrimination are broken by an individual, challenging inappropriate language, challenging any work colleagues who are demonstrating discriminatory behaviour towards another individual or a group of people and also implementations of government policies and guidelines on discrimination.

An example of identifying and challenging discrimination would be if a care worker in a care home saw a fellow care worker treating one individual a lot different to the rest in a negative manner, calling them rude names and shouting at them just because they are of different race, then the care worker could either speak to their colleague about this informing them to stop or go to their manager who can then investigate and take the right measures to ensure the discrimination stops.

A difficulty with this could be that a staff member doesn’t have much confidence and feels too scared to speak to their manager about an incident they have witnessed, to overcome this difficulty staff members can use the ‘whistle blowing policy’ Every health and social care setting has a whistle blowing policy which is when a worker reports suspected wrongdoing at work. Officially this is called ‘making a disclosure in the public interest’. A worker can report things that aren’t right, are illegal or if anyone at work is neglecting their duty, this is all done anonymously.

Promoting individuals’ rights, choices and wellbeing

Active promotion of individuals’ rights, choices and wellbeing can be demonstrated in the way care workers in a health and social care setting work one to one with service users. By offering people a choice related to their care can make a big difference to how that service user feels and responds to the service, as they will feel more in control of their care and treatment, which will empower the individual. Choices from food to personal care are all vital and key to the services offered by health and social care workers, these choices are central to the wellbeing of the individual, such like what clothes to wear that day or what to eat that day, all of this promotes the individuals rights and wellbeing. “In health and social care, choice is being taken into much wider avenues through the way we access and use the public services available to us” (BTEC National Health and Social Care Book 1, Stretch, page 93, 2007).

A problem with this could be that a staff member is not aware of the fact they should offer all service users a choice to make them feel empowered, to overcome this the employee (manager) should ensure that all staff members are appropriately trained in the area, and any new staff members are aware of this, so that all service users can be offered a choice.

Another difficulty is that staff members may be aware they have to offer a choice to service users, but may have a bad attitude towards this and purposely not give services users a choice and therefore not empowering them, to overcome this all settings need to keep updating training, and ensure that all staff members are following the rules and regulations of such policies and if they are not to take appropriate actions. Also to help overcome this difficulty the settings should have copies of some policies on the wall in an office, and the rest available to view by staff members at any time, this will ensure that any queries about policies or Acts, such as the disability discriminatory Act, can be sorted by checking the policy itself or asking a higher member of staff like a manager. All policies must be kept up to date.

Policies and procedures

Policies and procedures are designed determine all key choices and actions, and all activities take place within the limitations set by them. Procedures are the precise methods that are set in place to express policies in action in day-to-day operations of the health and social care setting. Together, policies and procedures ensure that a point of view held by the higher authority such as a manager of the health and social care setting is turned into steps that result in an outcome compatible with that view. An example of a policy in a health and social care setting would be the ‘anti-harassment policy’, ‘organisations and work places must have a policy in place, by law, which deals with issues of harassment or bullying, whether it is on the grounds of sexuality, race, ethnicity, gender, beliefs, sexuality orientation, marital status or disability’ (health and social care, book 1, stretch, 2012, page 76) this supports anti- discriminatory practice because when someone is harassed or bullied it is often on the grounds of discrimination, so this policy is against this happening which will help protect service users when they are in health and social care settings.

Another example of a policy or procedure is the ‘Complaint procedures’, all health and social care organisations must have this procedure by law, the procedure states that if somebody complains, they have the right to, have their complaint dealt with efficiently, have their complaint properly investigated, know the outcome of any investigation into their complaint, take their complaint to higher authority and receive compensation if they have been harmed, this will support the anti-discriminatory practice because if someone puts in a complaint about discrimination, or anti-discriminatory practice, then the organisation will have to follow the rules of the complaints procedure so the complaint will be dealt with properly and hopefully improve the anti-discriminatory practice in that health and social care setting.

Also another example for a policy that supports the anti-discriminatory practice would be the ‘Confidentiality’ policy. The guidelines on this are clearly stated in the data protection act. Every health and social care professional will have to make sure they keep information about their service users confidential. The only time that confidentiality needs to be broken is when there is a risk of the individual harming themselves, hides abusive or potentially abusive situations or threatens the life of an individual.

This helps support anti-discriminatory because service users will feel like they can trust their care workers and not feel like that care worker will abuse that trust and humiliate the service user by not keeping their information confidential, so the service user will feel no matter who they are the care workers have to keep their information confidential, so they cannot be discriminated against and have their information leaked by care workers.

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