1 Understand Partnership working
Care and Social Services Inspectorate Wales (CSSIW) – We have inspectors who keep a check on our home they are responsible for inspecting social care and social services to make sure that they are safe for the people who use them. They are the regulator for social care and social services in Wales, from child minders and nurseries to homes for older people. They aim to: Provide independent assurance about the quality and availability of social care in Wales Safeguard adults and children, making sure that their rights are protected; Improve Care by encouraging and promoting improvements in the safety, quality and availability of social care services. Inform policy, standards and provide independent professional advice to the people developing policy, the public and social care sector. In Safe Hands – The role of Care and Social Services Inspectorate Wales (CSSIW.) It reflects the integration of the former Care Standards Inspectorate for Wales and the Social Services Inspectorate Wales. The report details the roles and responsibilities of CSSIW in relation to other statutory bodies.
This includes local authorities who have the lead role in coordinating the development of local policies and procedures in adult protection. Care Council for Wales – We are registered with the care council for wales they are a leading role in making sure the workforce delivering social services in Wales is working to a high standard. This includes developing a confident and competent workforce in social services and childcare. They can work effectively, make well-informed judgments, based on up to date evidence, in the best interests of the people they work with. Code of Practice for Workers – The Code for Workers sets down the standards of conduct expected of social care workers. It will ensure that workers know what is expected of them and that the public know what standards of conduct they can expect from care workers. In the case of people who are registered breaking the codes may lead to investigation and action by the Care Council. Code of Practice for Employers There is also a Code of Practice for Employers, which applies to all employers across the social care sector regardless of whether they are public, private or statutory organisations.
The Code for employers sets out how employers should meet their responsibilities for managing and supporting their staff and ensuring that they do their jobs well. The enforcement of the Code for employers will be a matter for the Care and Social Services Inspectorate for Wales. National Service Frameworks – Are Frameworks for a range of situations and service user groups outlining best practice and partnership working (Example) National Service Framework (NSF) for Older People in Wales aims to improve health and social care services and access for older people through the setting of evidence-based standards. The NSF consists of 10 key standards, which set out the rationale and evidence base, followed by key actions required: Rooting out Age Discrimination, Person-centred care, Promoting health and well-being, Challenging dependency, Intermediate care, Hospital care, Medicines and older people, Stroke, Falls and fractures and mental health in older people.
Disclosure & Barring Service (DBS) Checks (Formerly Criminal Records Bureau (CRB) – The checking service allows me to access the criminal record history of people working, or seeking to work, in certain positions, especially those that involve working with Children or Adults in specific situations. Access to the DBS checking service is only available to registered employers who are entitled by law to ask an individual to reveal their full criminal history, including spent convictions – also known as asking ‘an exempted question’. An exempted question applies when the individual will be working in specific occupations, for certain licenses and specified positions. These are covered by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. The minimum age at which someone can be asked to apply for a criminal record check is 16 years old.
There are two levels of criminal record checks: Standard – Details of an individual’s convictions, cautions, reprimands or warnings recorded on Police central records and includes both ‘spent’ and ‘unspent’ convictions Enhanced – The same details as a Standard check, together with any information held locally by Police forces that it is reasonably considered might be relevant to the post applied for. Enhanced with a DBS Barred List check: Child barred list information is only available for those individuals engaged in regulated activity with children and a small number of posts as listed in the Police Act regulations, for example prospective adoptive parents.
Adult barred list is only available for those individuals engaged in regulated activity with adults and a small number of posts as listed in the Police Act regulations. Child and Adult barred list is only available for those individuals engaged in regulated activity with both vulnerable groups including children and a small number of posts as listed in the Police Act regulations. DBS Adult First – an individual can be checked against the DBS Adult barred list while waiting for the full criminal record check to be completed
Different Departments in Social Services
(Monitoring Contracts) – They work with the home to make improvements and to acknowledge good practice. This is done through baseline assessments, which involve visits to the care home to assess how we work on a day-to-day basis. These visits aim to compliment, rather than duplicate, other organisations such as CSSIW. As a result of the baseline assessment, there will sometimes be situations where action needs to be taken and this will be made clear to the home. There will also be opportunities for them to work alongside the home and to assist the home. (Contact Assessment Team (CAT) Safeguarding Adults) – The home has to report suspected abuse of an older person; we have to contact the Adult Protection Team in our Local Authority. Social Services Contact Assessment Team: (01978) 265083 Out of hours: (01352) 753403
Police: 0845 607 1002
(DOL’s) – The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The safeguards should ensure that a care home, hospital or supported living arrangement only deprives someone of their liberty in a safe and correct way, and that this is only done when it is in the best interests of the person and there is no other way to look after them. Example: If I need to provide care in a way that will deprive someone of their liberty, me being the manager of the home is responsible for applying for an authorisation for the deprivation of liberty. It is unlawful for the home to carry out an action that will deprive someone of their liberty, without an authorisation for this action being in place. In an emergency, I would have to put in urgent authorisation, but I must apply for a standard authorisation at the same time.
This urgent authorisation is usually valid for seven days, although the supervisory body may extend this for up to another seven days in some circumstances. . (Because of this, the home has put in 20 authorisations to Dols) Social Workers – Some of our residents have a social worker; the Social workers provide appropriate advice, support and resources to individuals who are experiencing personal difficulties to help them overcome their problems. Examples: assessing, counselling and offering advice to clients, arranging appropriate care, resources or benefits, liaison with relatives, colleagues and other professionals.
Workforce Strategy & Development , Wrexham county Borough Council (Social Care Training) – Provides Wrexham Area with free training Courses for Health and Social Care workers Different Departments from the NHS / Health Board or Private Physiotherapist (Physio) – If needed, we contact the residents G.P to refer the resident to a Physio they can help tackle weakness or paralysis. They help stroke survivors to regain mobility and muscle control (for example by helping them learn to balance or move around again).
Occupational therapist (OT) – if needed, we contact the residents G.P to refer the resident to a OT they can help the resident do the day-to-day activities that can be difficult to do after a stroke, such as washing, dressing and eating. They also help people return to their normal leisure activities and support them as they learn skills so that they can mobilise safely.
Speech and language therapist – If needed we ask the residents G.P to refer the resident to a speech and language therapist, they can tackle the damage done to communication skills, so that stroke survivors are more able to speak, read write and understand. They also help with swallowing problems that may occur as a result of stroke.
Dietician – If needed we ask the District Nurses or the residents G.P to refer the resident to a Dietician, they assess dietary requirements and can provide staff advice on eating a healthy diet, especially when residents have weight problems or have diabetes. A healthy diet is important for reducing the risk of strokes in the future.
Private Dentist or NHS Dentist – Most of our residents don’t have their own private dentist, this is mostly due to them not having any teeth. Sometimes we have to contact an NHS Dentist on their behalf. The NHS Dentist provides any treatment residents need to keep their mouth, teeth and gums healthy and free of pain. Depending on what they need to have done, they should only ever be asked to pay one charge for each complete course of treatment, even if they need to visit the dentist more than once to finish it. They will not be charged for individual items within the course of treatment. The NHS Dentist also provides a service of coming within the care home. Private or NHS Audiology – Some of our residents have problems with their hearing therefore would have to see an audiologist. An audiologist is someone who diagnoses and treats a patient’s hearing and balance problems using advanced technology and procedures.
The majority of audiologists work in healthcare facilities, such as hospitals, physicians’ offices, and audiology clinics. District Nurses – come to our home every 2-3 days (more if needed) they assess the resident’s needs and monitor the quality of care they’re receiving. As well as providing direct patient care, district nurses also have a teaching and support role, working with staff to enable them to care for the residents. They can also help with any bowel and bladder problems; they can do continence assessments and help with continence products. (CPN)Community Psychiatric Nurse – Some of our residents have a diagnosis of dementia and can have challenging behaviours the CPN can help to talk through problems and give practical advice and support to staff. They can also give medicines to residents and keep an eye on their effects.
Nurse therapists have had extra training in particular problems and treatments, such as eating disorders or behaviour therapy. Doctor – Each resident has their own named doctor also referred to as a G.P. A doctor is someone who maintains or restores human health through the practice of medicine. He or she will diagnose and treat human disease, ailments, injuries, pain or other conditions. A doctor can be found in several settings, including public health organizations, teaching facilities, private practices, group practices and hospitals. NHS or Private Opticians – When the optician comes to see the residents, he also comes with an ophthalmic practitioner. A ophthalmic practitioner will check the quality of the residents vision and eye health. Both optometrists and ophthalmic medical practitioners are trained to recognise abnormalities and signs of any eye disease such as cataracts or glaucoma. If necessary, they will refer the residents on to their GP or an eye clinic for further investigations. They also prescribe and fit glasses and contact lenses for the residents.
NHS or Private Chiropodist – The home has a private Chiropodist, she’s sometimes known as podiatrist, she can treat a variety of foot and lower limb abnormalities, from verrucas and ingrown toenails to arthritis. Chiropodist work with people of all ages and play an important role in helping our residents stay mobile and independent. Advocate – The home tries to be supportive and helpful to all our residents but this may be difficult at times if the resident thinks we are doing things they disagree with, even though it’s what they want. In cases like this I would give the residents information on different advocate services, depending on the needs of the resident (Example) – A citizen advocate is a volunteer, who works as part of a citizen advocacy scheme. A citizen advocate would usually work with you on a long-term and one-to-one basis.
Unlike a mental health advocate, a citizen advocate does not have to have personal experience of a mental health problem. – Mental Health Advocacy is a statutory form of advocacy which was introduced in 2009 as part of amendments to the Mental Health Act. Anyone who is detained in a secure Mental Health setting, under the Act, is entitled to access support from an Independent Mental Health Advocate (IMHA) Medicines Management Nurse – she comes to the home to support us with the Meds Management and service improvement, she works across Health and Social Care to support Domiciliary, Care Homes and Nursing Homes. Smart Care Training – The Smartcare Teaching Care Centre offers us expert, affordable training, they offer innovative courses in personal development, supervisory, mandatory and regulatory training.
I being the home manager at Oak Alyn Hall, I am responsible for resident’s placements; in my absence the deputy manager is responsible. All residents’ enquiries a placement are dealt with by Myself, the deputy manager or the senior on duty at the time, it is designed and monitored in the following ways to ensure the goals are achieved and maintained. (Standard 28)I will, or the member of staff on duty at the time of the enquiry will follow the procedure by entering the enquiry into the residents enquiry file. (Standard 2) After completing the form it will be filed at the front of the enquiry file, where myself or the deputy manager will follow up the enquiry with a courtesy telephone call within 48 hours, unless agreed otherwise, with the enquirer. I or the deputy will suggest to them to visit the home at any time or alternatively if they would like to see me. (Standard 4) I will or the deputy will make an appointment with the enquirer, confirm this in writing and enclose a brochure pack of the home for them to look at. (Standard 1)
The visit to the home will be conducted by me or the deputy; I will invite them to the office or a quiet room, offering them refreshments and to establish the nature of direct care the enquirer is looking for, permanent or for respite. I will show the enquirer the facilities on offer i.e. lounges, dining rooms, shower rooms, toilets and special needs facilities bath hoist and moving equipment, (Standard 35) I would explain the guidelines for moving equipment and risk assessments. I would show them the bedrooms available with all en-suite facilities. Discuss the menus, choice and dietary needs, medical services, G.P, optician, chiropodist, social activities, religious practice and the purpose of the care plans I involve them at every point so they have the right to consent and also they fully understand.(Standard 9 / Standard 15) I explain to the enquirer that the resident is welcome to visit the home and to move in on a trial basis to give them time to decided what they want. (Standard 4)
When it is established that the admission would be fee assisted this will be explained to the enquirer, the person seeking admission will need to satisfy certain financial criteria if they are to get help with their fees. (Standard 29)The relative or person involved will need to discuss the matter with a social worker, If the enquire wishes, I will give them some telephone numbers of social workers, who will then carry out a financial assessment. I will then explain to the person seeking admission that I have to carry out a pre-admission assessment to maintain we can meet their care needs, (Standard 2) I explain to the enquirer that the pre-admission assessment could be done now or at a later date. If at a later time, I arrange a date and time whether they are in hospital or at home to go and access the potential resident. I write all the details down on the pre-assessment from talking to the potential resident if the resident has problems communicating then I will ask the residents family, if the resident has no family, I speak to the ward sister if in hospital or their social worker.
I explain throughout the assessment about the guidelines, risk assessments, menu, choice and dietary needs including any swallowing difficulties, the purpose of care plans, medical services e.g. G.P, optician and chiropodist, and I explain the social and religious activities offered by the home.(Standard 15) I provide the opportunity to read the general information pack about the home which I give to the potential resident. (Standard 1)Prior to admission i explain to the resident that they can bring their personal possessions with them the extent of which we both agree on. When the pre-assessment is completed, I then decide if our home can meet the resident’s needs. I arrange a date for admission to the home, which is convenient to the resident and send a letter of acceptance to the resident.(Standard 2) On the day of admission I arrange for myself and their appointed key-worker to be there to welcome them into the home.
I ensure a service user guide (Standard 1) is in the resident’s room explaining all about their rights, charter of care information about the home and they have a written contract.(Standard 5) I ensure the senior on duty and the residents key-worker offer to assist the resident with unpacking, offer the resident and family refreshments, inform the resident and family where the manager’s office is located and how to use the nurse call system, then leave the resident and family with time to adjust. After settling in, the senior and key-worker to introduce the new resident to other residents. Next is the care plan, as we are all individuals and there have individual’s needs, I know it is important for each resident to have a care plan that is individually tailored to their specific requirements.(Standard 6) I have found there is nothing annoying than having someone else decides what is best for you. After all, as an adult they have had experience of their needs that no one else could possibly have.
In addition to the policy and procedure of assessment and care planning, as well as other organisational care factors. I know it is important to gain the participation of the resident themselves in their own care needs and wishes. Occasionally I have found that due to an inability to comprehend, the resident is unable to contribute, in this case I would gain relevant information from significant others, these would probably include; family, social worker, C.P.N.s, G.P, hospitals and other health care professionals. In order for me and their key-worker to achieve full involvement of the resident, we must first open the lines of communication. Whether this involves an advocate, using specifics such as sign language, pictorial communication or an interpreter if translation is required. (Standard 8) A clear link must be made. We make sure the resident is at the centre of any care plan and any needs identified or perceived will be agreed on as being what that resident desires and needs.
I make sure the plan fits the resident, not the home. First me and their key-worker will complete the daily living and needs assessment form to enable staff to have initial information, then a manual handling risk assessment, all general risk assessments i.e. hoist, bath- hoist, wheelchair etc, a nutritional risk assessment and a waterlow risk assessment. (Standard 18) Then over the next few days the Key-worker and the senior on duty will start to compile the residents care plan, i.e. sight, hearing and communication –(EXAMPLE) wears glasses, needs support to clean them, wears hearing aids needs help to put batteries in. Oral health, continence, medication, mental state and cognition, social activities, hobbies, religious and cultural needs etc.(Standard 15) I ensure the resident is involved throughout the whole process of care planning. It is important that I ensure the staff team know about the process and how to gain agreement from the resident.
Any aspirations, hopes and fears the resident may have as well as their personal views must be included. I ensure that all who are involved are aware of the need for ongoing discussion with the resident as very often things can change or new fears and hopes emerge. Once the goal is agreed, it is then time to think about how the plan may be implemented. I ensure all residents are involved in any review; opportunities for feedback of the resident opinion must be considered and made available, also I ensure when the resident agrees with their care plan that they sign the agreement form, if capable or their representative (if any) I make sure that all staff are aware of the monitoring process and the need for accurate reporting and recording skills.(Standard 7)
Children and Young people – Oak Alyns Policy and Procedure (minimum age to work in social care) Only allow people over the age of 18 to deliver personal intimate care (mostly personal hygiene tasks). People under the age of 16 can do the work supervised but it does mean that a 16-year-old’s work opportunities are limited. However, as a 16- to 18-year-old, they will be able to feed service users, talk to them and complete other companionable tasks as well as helping them with their mobility such as pushing wheelchairs (only and after training) Some domestic chores, like making beds, may also be expected. 2 Be able to establish and maintain working relationships with colleagues.