Tma_06

TMA 06 ANNE MARIE PROBERT 20TH APRIL 2013 The statement “ the only way to make care safer is to employ staff with the right attitude” is an oversimplification. Safer care is dependent on many factors, not simply employing staff with the right attitude. I shall explore this in this essay. Safer care is care that addresses all aspects of a service users needs, physical , emotional and psychological , whilst promoting independence , dignity and respect. Staff need to be adequately trained, supported and managed and need to be aware of guidelines and protocols affecting their work. Care workers also have a duty to acknowledge when they are not suitably trained and take steps to rectify this, Code of Practice for Social Care Workers. Properly trained staff will help towards making care safer. In block 5 we meet Marie who is new to caring and is not properly trained in care. In addition, she does not know who to go to to get help and advice and is unaware of protocols and guidelines applicable to her. The Care Quality Commission monitors the performance of registered care providers and has the power to force changes if standards are not being met. This also helps to make care safer. Staff learn how to deal with challenging behaviour and what language is appropriate to use. The use of more respectful, less problem orientated language has made care less confrontational, Lowe and Felce 1995. Challenging behaviour is dealt with via predetermined sequence of events, and physical intervention is used only at a minimal level which must stop as soon as the behaviour subsides, Harris et al 1996. This helps to contain the situation and is safer for all parties concerned. The responsibility for safer care does not only rest with the care staff. Service Users have a responsibility, where they are able, to be assertive and clear about the care they need and expect. Some Service Users employing Personal assistants, say that they prefer to train them themselves and they can then have exactly what they need, not what has be predetermined through training, Leece and Bornat 2006. This makes care safer because is it is tailored to the needs of the individual. Staff must also be aware of guidelines and protocols concerning the way care is delivered and be prepared to “blow the whistle “ on inappropriate or unsafe practice. The Code of Practice for Social Care Workers states that staff must use the established procedures to challenge abusive or dangerous staff behaviour. Staff who report such incidents will be protected as long as the disclosure is made in good faith and not for personal gain. Care is safer then because the service user is not expected to report behaviour formally, the staff can do so if they witness anything untoward. The care environment needs to be safer in order for the care to be safer. In block 5 we visit Cedar Court which has a culture of “ Bedroom Abuse”. This is not the fault of the attitude of the carers, it is a culture which has grown over time and is now taken for granted. Lee- Treweek, in the Reader, describes residents being treated as “Bodies that need to be done”. The residents are depersonalised, we meet Alan, who feels lonely and helpless and as a result is frustrated and angry. The staff ridicule him and laugh at him which makes Alan feel humiliated. This is not safe care, Alan is not being treated as individual, he is being abused. The “No Secrets” definition of abuse in the reader says that there are 6 types of abuse, physical, sexual, financial, neglect, psychological and discriminatory. Record keeping is an important concern in keeping care safe. Records provide continuity for staff and service users, and remove the need to obtain the same information over and over again Records protect staff members if allegations are made against them if something goes wrong. Hand written records are sometimes illegible and therefore it is generally felt that computerised records are better although there may be difficulties such as security when accessing electronic records. The records are vital to enable staff members to work as part of a team, and for continuity of care to continue even if there is a change in the staff. Records also help to co ordinate care between different agencies, which helps to ensure that nothing is overlooked, thereby making care safer. Signed care records confirm whether something was agreed or carried out, which removes doubt. Care records also provide information which may assist public health in general, for example recording the numbers of children who receive the MMR vaccination. The Freedom of Information Act 2000 allows people to access their own medical records, unless it is detrimental to them to do so. In Block 5 we meet Dan, whose mother has spoken to their GP relating to Dan’s drug habits. When Dan asks to see his medical notes, this entry is omitted as it was felt that Dan may harm his mother for talking about him, and also Dan himself may be angry or distressed by the notes made about himself. Accessing their own records means service users can correct mistakes in their records which makes their care safer. The Campaign for Freedom of Information 1990 cited an example where a patients records were in a shambolic state and did not even apply to her. They were records of another patient with the same name seeing the same doctor. Potentially, these incorrect care notes could have been harmful to the patient if action was taken based solely on the information contained therein. Accountability is very important in making care safer. Social care workers must take responsibility and be accountable for the quality of their work, and also ensure that they are up to date with their knowledge and skills, General Social Care Council 2002. Employers must make explicit statements about responsibilities and have procedures in place to make outcomes visible. There should be penalties for poor performance and an official mechanism for looking at performance, perhaps in the form of a review with a manager. There also needs to be a procedure in place to look at a situation when things go wrong. This all leads to a safer care environment for both staff and service users. Accountability can be easier if the lines of responsibility are changed so that both parties work together and are accountable directly to each other, George 2003. The internet has provided access to lots of information relating to medical and care issues. Service Users are in a position to research and understand their situation and therefore challenge advice or decisions if appropriate to do so. Care is made safer because the service user does not have to rely only on the advice given. There is lots of evidence based research available on the internet, which Health Care professionals may not have been aware of. Evidence based care is vital to making care safer, because it is based on evidence of what treatments or management options have worked in previous cases. It also prevents harm, unnecessary interventions and waste of resources. Evidence relating to bed rest found that in many cases it did more harm than good, Allen et al 1999, and therefore advice was changed. Evidence based care can help resources not to be wasted, for example a study showed that most ear infections in young children clear up on their own and therefore costly treatment with antibiotics was of no benefit, Reveiz et al 2007. Evidence based care is beneficial because it is based on care which we know works, not on popularity, anecdotal evidence or opinions, Gambrill 1999. Care workers have access to information that is often regarded as confidential. According to the Department for Education and Skills 2006, confidential information is defined as information which has been disclosed with an understanding that it will remain confidential. Such information is vital to making care safer, as it is all about the service user. The service user may have given consent, either implied or explicit, for information to be shared appropriately, ie with other health care professionals who are involved. There may be times however, when confidentiality cannot be maintained as it is not in the best interests of the service user. The department for Children and Schools 2007 stated that early disclosure of confidential information can often protect a child from future harm. In conclusion, employing staff with the right attitude will certainly help towards safer care, because these staff are more likely to adhere to the rules, protocols and guidelines set down. In addition, they will keep better records and be aware of training requirements. Person centred values should be at the forefront of a carers attitude to their work, however, staff who have a less desirable attitude can be good at their job, and can be provided with training and support in order to make their attitude more acceptable, and therefore make the care safer.