Standard 5 Principles for implementing duty of care

Transcription

1 Standard 5 Principles for implementing duty of care Your Name: Workplace: Start Date: Completion Date: Contents 1. Understand how duty of care contributes to safe practice 2. Know how to address dilemmas that may arise between an individual s rights and the duty of care 3. Know how to recognise and handle comments and complaints 4. Know how to recognise and handle adverse events, incidents, errors and near misses 5. Questions

2 Standard 5 Principles for implementing duty of care 1. Understand how duty of care contributes to safe practice 1.1 Explain what it means to have a duty of care in your work role Every individual should be supported and enabled to live in an environment which is free from prejudice and safe from abuse. Your responsibilities under the duty of care are to do everything reasonable within the definition of your job role to make this happen. Duty of Care means providing care and support for individuals within the law and also within the policies, procedures and agreed ways of working of your employer. It is about avoiding abuse and injury to individuals, their friends and family and their property. A negligent act could be unintentional but careless or intentional that results in abuse or injury. A negligent act is breaching the duty of care. If an individual has evidence that you have been negligent, you are likely to be disciplined. You could lose your job and you could have legal action taken against you. 1.2 Explain how duty of care contributes to the safeguarding or protection of individuals In your role you have a duty of care to raise any concerns you may have about any aspect of your work. These can range from inadequate working conditions, poor equipment, poor practice by other staff; to raising concerns about potential abuse cases and situations of neglect. It is your duty of care to safeguard individuals from harm. All employees should report any concerns of abuse they have. These might include evidence or suspicions of bad practice by colleagues and managers, or abuse by another individual, another worker or an individual s family or friends. If you do not work in this way, you could be considered negligent or incompetent. If you are in any doubt at any time, you must discuss any issues you have with your supervisor / manager. Local authorities have Safeguarding Adults policies and procedures that will be published on their websites or available from their Safeguarding team. You will learn about Safeguarding in more detail in Standard 6. It links closely with your duty of care. Locate the Safeguarding Adults policy and procedures that are in place for your local area Page 2 of 15

3 2. Know how to address dilemmas that may arise between an individual s rights and the duty of care 2.1 Be aware of potential dilemmas that may arise between the duty of care and an individual s rights During your work you may find yourself in situations where the individuals you are supporting do not agree with what you believe is best for them. Who knows best? The individuals you support or you, a carer, the family? In situations where there is a conflict of interest or a dilemma between an individual s rights and your duty of care, it is best practice to make sure the individual is aware of the consequences of their choice and that they have the mental capacity to understand the risks involved in their choice. It is their right as an individual to be able to make informed choices about their own lives even if you disagree with their choice. It is the right of every individual in your care to make choices and take risks. It is your role to assist them in making those choices and reducing the risks without compromising their rights. An individual may be restricted if his or her behaviour presents a serious risk of harm to his or herself or to other people. People who receive care and support are considered to be at risk, and as such the law requires that an assessment be carried out to look at any possible risks there might be to the individual or to others. The aim of this assessment is not to remove the individual s right to take risks, but to recognise and reduce them where possible to an acceptable and manageable level. Mental Capacity Act 2005 We looked at the Mental Capacity Act (MCA) in Standard 1. Outcome 3.2. MCA has a set of criteria to determine whether a person is able to make informed decisions and choices. The term a person who lacks capacity means a person who is unable to make a particular decision or take a particular action for themselves at the time the decision or action needs to be taken. It is important you are familiar with what the MCA says as you may be concerned that an individual you are working with shows signs of lacking the capacity to make decisions for themselves. This could happen to an individual at any time and you will need to ask for professional support to determine if the individual does lack capacity. Page 3 of 15

4 2.2 Be aware of what you can and cannot do within your role in managing conflicts and dilemmas If individuals insist on doing something that you disagree with, you can only advise and encourage them. You cannot force them to do anything. For example: If an individual refuses to take medication and their well-being depends on this medication, you cannot force them to take the medication. You should immediately contact you supervisor / manager and seek advice. You should also make sure you record what has happened and the action taken in the care or support plan. Consider this scenario: The care and support plan for a physically disabled individual includes; the support worker supporting them to go to a café or restaurant every week so they can dine out as they are unable to do this alone. The individual wants to eat at a McDonald s burger restaurant every week. The support worker is vegetarian and believes that burgers are unhealthy and shouldn t be eaten that regularly. The individual has the mental capacity to make this kind of decision and it is one of their desires to maintaining a fulfilling life. Which of the following should the support worker do? 1. Refuse to take the individual to McDonald s and insist they go somewhere else 2. Accept it is the individual s choice and support them to go to McDonald s 3. Tell the individual the facts about eating at McDonald s and ask them if they would like to try somewhere different. Then support them to go to McDonald s if this remains their choice. Scenario Answer: The support worker should tell the individual the facts about eating at McDonald s and ask them if they would like to try somewhere different. Then support them to go to McDonald s if this remains their choice. This allows the individual to make an informed choice about where and what they eat. It is essential that the support worker uses an encouraging and supportive tone of voice and words and that the individual does not feel bullied or harassed into doing what the support worker wants them to do. Don t forget you might want to consider whether the individual has the capacity to make decisions or whether you need to seek additional advice and support from your supervisor / manager. Page 4 of 15

5 2.3 Know who to ask for advice about anything you feel uncomfortable about in relation to dilemmas in your work You should know the limits of your role and not do or say anything outside of this. It is important that you know who to go for if you need advice because you are in a situation that you are not comfortable with. Your supervisor / line manager will tell you who else you can talk to if they are not available. You should always seek advice from your supervisor / manager in relation to dilemmas in your work 3. Know how to recognise and handle comments and complaints 3.1 Be aware of any existing comments and complaints procedures in accordance with agreed ways of working Comments and complaints can be made by individuals, workers, carers, family members, in fact anyone who feels there is something wrong that needs to be addressed. Many people, especially the individuals you support, do not know how to make comments or complaints. Some individuals will feel uncomfortable about making complaints as they do not want to cause trouble and they do not want to risk services being reduced or removed. It is therefore important that you know what the procedures are and can advise them what to do. Every employer should have a complaints procedure in place that you can follow. This will enable people to express their displeasure of a service, person, situation etc. It is useful if the procedure includes a flowchart of how a complaint is dealt with so you can see and follow the process. Every complaint should: Be taken seriously and dealt with promptly and fully Be acknowledged within a specified time Have time limits for preliminary investigation Be monitored and progress reported to the complainant The Care Quality Commission (CQC) provide detail on how complaints should be dealt with in their Essential Standards of Equality and Safety. CQC state what people who use services should experience, as: Being sure their comments and complaints are listened to and acted on effectively. Knowing that they will not be discriminated against for making a complaint. Page 5 of 15

6 CQC state this is because providers who comply with the regulations will: Have systems in place to deal with comments and complaints including providing people who use services with information about that system Support people who use services or others acting on their behalf to make comments and complaints Consider fully, respond appropriately and resolve, where possible, any comments and complaints Know what you can and cannot do within your role in handling comments and complaints and how you should respond If you receive positive comments about your service or any aspect of the service your employer provides, it is important that you record these comments and pass them on to your supervisor / manager. If the individual making the comment is able to write, it is worth asking them to put the comment in writing or you might be able to help them to do this. Positive comments are motivating and supportive so people know they are doing things right. Your employer should give you clear and precise information about your role and responsibilities in dealing with complaints Some individuals may need an Independent Advocate to support them to make a complaint and to support them until the complaint has been dealt with or resolved. They will be able to give impartial advice, help to write letters, attend meetings and make sure that the person complaining s views are heard, especially if the person has communication difficulties. Independent Advocates can usually be provided by voluntary organisations. If you use a search engine on the internet and type in Independent Advocates you will find lots of different organisations providing advocacy services. It would also be worth finding out what organisations can provide Independent Advocates locally. 3.3 Know who to ask for advice in handling comments and complaints Larger employers may have a comments and complaints specialist who you can refer people to. In smaller organisations or if you work with an individual in their home, you may be responsible for dealing with the complaint yourself. Check with your supervisor / manager what the complaints procedures are and who you should refer people to Page 6 of 15

7 3.4 Recognise the importance of learning from comments and complaints to improve the quality of service Comments and complaints are really important because they enable you to learn how people perceive the support and service you provide. This enables you to make improvements to the overall quality which leads to better outcomes for the individuals you work with. Discussion about and learning from complaints can be done during supervision or team meetings depending on the nature of the comment or complaint. Your employer might send out surveys to individuals you support asking questions about the quality of services or you might participate in a 360 degree feedback about your own performance. You can use the responses to look at how well you are doing and what areas can be improved upon. Whilst it might seem like a negative thing to receive a complaint, if it is handled well, it can lead to great improvements and benefits for everyone involved 4. Know how to recognise and handle adverse events, incidents, errors and near misses 4.1 Know how to recognise adverse events, incidents, errors and near misses that are likely to affect the well-being of individuals Whilst working, it is important that you can recognise events, incidents, errors and near misses likely to affect the well-being of the individuals you support. It is also important to recognise near misses so that steps can be put in place to ensure they do not become incidents or accidents in the future. Accident: This is something that happens that results in injury, ill health or death. Incident: This is something that has almost or could have happened that might not have caused harm this time but could cause injury, ill health or death Adverse events: These are accidents and incidents. Risk Assessments: These are simple careful examinations of what could cause harm to individuals, so you can weigh up whether you have taken enough precautions or whether you need to do more to prevent harm. Page 7 of 15

8 Care and support plans should have formal risk assessments that will guide you but circumstances can change every day and you will make judgments about the risks of what you are doing before undertaking all tasks. Risks must be identified before tasks are undertaken. Think about the four main areas you are working in: What you have to do The individual and their capability The task that needs to be done Your surroundings You should always record any changes and contact your supervisor / manager or the person responsible for the individual s care and support plan if you feel a risk assessment should be formally changed. 4.2 Be aware of what you can and cannot do within your work role in relation to adverse events, incidents, errors and near misses You should only take action and become involved in certain situations if you have been appropriately trained, observed or signed off as competent. Examples: If you are the first person to attend an incident where an individual may need Emergency First Aid, you can only do what you have been trained to do. You must always make a primary survey and never go straight to the casualty without making sure the area is safe. If you discover a Fire, you should immediately raise the alarm. You should not tackle a fire with an extinguisher unless you have been trained to do so. You must not put yourself or others in any danger. It is essential that you leave the building as quickly as you can supporting others to leave where you can. It is essential to write down what happened immediately after the event so you will be able to refer to your notes about what happened rather than rely on your memory which might not be accurate, particularly if you felt stressed. You should always reflect on situations to consider if you handled things differently or behaved in a different way, would the outcome have been any better for anyone involved. This gives you the opportunity to consider your level of skill and your confidence and whether you need further support or training. Page 8 of 15

9 4.3 Know the procedures and to whom you should report any adverse events, incidents, errors and near misses Informing individuals of their choices and the risks involved enables you to support their empowerment and independence. If you witness anything you feel is risky or unsafe, it is necessary to report your concerns to your manager or supervisor. It takes a great deal of courage for an individual to raise concerns about poor practice or abuse in their organisation. As a care worker, it is your duty of care to report anything that is likely to affect the wellbeing of the individuals you support. An approach of zero tolerance must be taken to ensure that adults at risk are protected. If you have suspicions or evidence that an individual or individuals might be being abused, you have a duty of care to report this. The Public Interest Disclosure Act protects employees from victimisation if they should need to report abuse or neglect. Whistle Blowing Your organisation may have a Whistle Blowing policy, which will protect you and your employment if you report your concerns. Whistle blowing is about reporting incidents of suspected or actual abuse or neglect. If a policy exists, it is recommended that you read this if you are in the position of needing to report something about your colleagues or employer. To Blow the Whistle on somebody or something means to report somebody for doing something wrong or illegal, especially within an organisation. Source Online Encarta English Dictionary. If you are not satisfied that a concern you have raised has not been addressed, then consult the policy again and follow instructions on who to contact next. All concerns should be reported accurately. If your concerns are not taken seriously, you must try another route. You must ask for help if you feel out of your depth with a particular individual or issue. Page 9 of 15

10 Questions: Understand how duty of care contributes to safe practice 1.1 Explain what it means to have a duty of care in your work role What does having a duty of care mean to you in your work role? 1.2 Explain how duty of care contributes to the safeguarding or protection of individuals How does your duty of care contribute to the safeguarding and protection of individuals? 1.3 Be aware of potential dilemmas that may arise between the duty of care and an individual s rights Give an example of a dilemma you might have at work where you believe your duty of care conflicts with an individual s rights and say what you would do? Page 10 of 15

11 What does the Mental Capacity Act say about an individual who lacks capacity? 2.2 Be aware of what you can and cannot do within your role in managing conflicts and dilemmas What should you do if an individual wants to do something that you think is risky? What should you do if an individual refuses to take their medication? 2.3 Know who to ask for advice about anything you feel uncomfortable about in relation to dilemmas in your work Who should you ask for advice about anything you feel uncomfortable about in relation to dilemmas in your work? 3.1 Be aware of any existing comments and complaints procedures in accordance with agreed ways of working What procedures or agreed ways of working are in place to raise comments and complaints in your work place? Page 11 of 15

12 3.2 Know what you can and cannot do within your role in handling comments and complaints and how you should respond What should you do if an individual would like to make a complaint but they find it difficult to explain things? 3.3 Know who to ask for advice in handling comments and complaints Where can you get additional support and advice in handling complaints? 3.4 Recognise the importance of learning from comments and complaints to improve the quality of service Why are comments and complaints useful? 4.1 Know how to recognise adverse events, incidents, errors and near misses that are likely to affect the well-being of individuals What is an accident and give an example? Page 12 of 15

13 What is an incident and give an example? 4.2 Be aware of what you can and cannot do within your work role in relation to adverse events, incidents, errors and near misses Describe what you would do if you came across an individual in their own home on the floor. Your answer should be based on the level of training you have had to date. You may wish to update your answer below if you receive further training. Update of previous answer: Page 13 of 15

14 You are in an individual s home and while you are putting the shopping away, the individual you are supporting is making a cup of tea. You notice that they are having difficulty holding the kettle whilst they are pouring boiling water into the teapot and nearly drop the kettle completely. What would you do? 4.3 Know the procedures and to whom you should report any adverse events, incidents, errors and near misses If an incident occurs while you are supporting an individual, who would you tell and where would you record this information? What is Whistle Blowing? Page 14 of 15

15 Shall we find out what you have learnt? Now that you have completed this section you can have a go at the online assessment for Common Induction Standard 5. To do this you will need to visit and log on by entering your username and password in the boxes provided. You will then be able to select Common Induction Standards then Standard 5. Don t forget to read the instruction page before you start. Once you have completed this assessment and had a discussion about the results with your line manager, you may want to do a little more learning and / or return to your results and record additional evidence. You can also print out the results pages (which include any additional information you have added) for your Induction Folder and CPD Portfolio. Copyright note for Managers and Employers The workbook(s) can be completed online or on a printed copy. You can make any changes, deletions or additions to suit your circumstances. You can personalise the workbook(s) by adding your organisation s name and logo. Please make sure that CIS-Assessment is credited for putting the workbook(s) together and providing them without charge. You cannot copy, reproduce or use any part of the workbook(s) for financial gain or as part of a training event that you are profiting from. Page 15 of 15