A8 - Providing Person-centred Care

• What is the purpose of the Mental Capacity Act (2005) plus Amendment (2019) in relation to healthcare?

  To protect rights, safeguard and support individuals over the age of 16 who may lack the mental capacity to make choices about their own treatment or care.
• What are the key principles of the Care Act 2014?

  Empowerment: individuals should be supported to make their own decisions based on best possible information

  Protection: service users who are in greatest need of support and protection

  Prevention: better to take action before harm occurs

  Proportionality: actions should be proportionate to the risk

  Partnership: working with range of professionals, groups and communities to prevent, detect, and report neglect/abuse

  Accountability: health and social care professionals need to be accountable for any activities in relation to safeguarding
• What is the role of the Care Quality Commission?

  Publish views on quality issues in health and care services

  Ensure services provide people with safe, effective, compassionate, high-quality care

  Focus on how services can improve

  Register providers

  Monitor, inspect and rate service

  Can take action to protect people who use services
• What is the role of the Health and Safety Executive?

  Ensure health and safety standards and regulations are adhered to

  Inspect health and care workplaces following health and safety incidents of a nonclinical nature

  Improve health and safety in workplaces
• What is the role of the Nursing and Midwifery Council?

  Ensures professionals have the knowledge and skills to deliver consistent, quality care that keeps people safe

  Sets education standards professionals must achieve to practice in the UK

  Registers professionals

  Expects registered professionals to uphold standards and behaviours set out in the NMC code

  Promotes self-reflection and evaluation of practice to improve services and encourage lifelong learning of professionals

  Can investigate reported incidents and take action
• What is the role of the Health and Care Professions Council?

  Regulate a range of health-related professionals

  Set standards for professionals' education, training and practice

  Register qualified professionals who meet required standards

  Can take action if professionals on the register do not meet standards
• What is the role of Ofsted?

  Responsible for regulating children's homes under the Care Standards Act 2000 where regulated activities take place

  Requirement to register with the CQC where regulated activities take place
• What is the role of the Information Commissioners Office?

  Promote and support information rights in the public interest, encouraging transparency and data privacy for individuals

  Carry out adults and advisory visits across health organisations in relation to personal data
• What are the typical care needs of a person?

  Nutrition and hydration

  Personal care

  General health and wellbeing

  Positive relationships

  Self-esteem

  Personal growth

  Independence
• What are the care needs in infancy (0 - 2 years)?

  Food, clothing, shelter

  Love, safety, a carer they can trust

  Activity and sleep

  Immunisations, protection from injury and illness

  Stimulation to learn new skills
• What are the care needs in early childhood (3 - 8 years)?

  Health - immunisations, personal hygiene, nutrition and balanced diet

  Exercise

  Rest and sleep

  Opportunities to play and learn

  Opportunities to develop social skills
• What are the possible care needs in adolescence (9 - 18 years)?

  Health - problems relating to menstruation, skin problems or issues such as eating disorders and self-harm, drugs and alcohol abuse

  Social and emotional needs - relationships, feelings and physical changes of adolescence or peer pressure and exam stress
• What are the possible care needs in early adulthood (19 - 45 years)?

  Pregnancy/contraception/fertility

  Emotional needs - relationships, work, personal social problems

  Possible injury such as broken bones

  Drug and alcohol problems

  Dietary intolerances

  Unexpected illnesses or accidents affecting physical and mental health
• What are the possible care needs in middle adulthood (46 - 65 years)?

  Menopause - may cause symptoms such as hot flushes, night sweats and mood swings

  Coping with stress due to work, redundancy, unemployment, family responsibilities

  Emotional needs due to, for example, relationship breakdowns or family responsibilities, or bereavement

  Illnesses may develop
• What are the care needs in late adulthood (65+)?

  Chronic health problems may develop

  Sensory problems

  Loss of mobility

  Emotional needs as a result of social isolation due to loneliness or feeling they are a nuisance/burden for their family to look after
• What are the NHS core values when providing care and support?

  Compassion - providing care that demonstrates kindness, empathy, respect and consideration for the individual

  Improving lives - involves finding treatments and aids that help individuals have a healthier and better life

  Respect and dignity

  Commitment to quality of care

  Working together for patients - staff in all parts of the NHS should work together to support individuals' care

  Everyone counts - no-one should be discriminated against on any grounds of prejudice
• What are the Six principles produced by the People and Communities Board?

  Care and support are person-centred

  Services are created in partnership with citizens and communities

  Focus is on equality and narrowing inequalities

  Carers are identified, supported and involved

  Voluntary, community and social enterprise and housing sectors are involved as key partners and enablers

  Volunteering and social action and recognised as key enablers
• What is the purpose of the Personalisation Agenda 2012?

  To put the individual first in the process of planning, developing and providing care, creating tailored support to the individuals needs and desires when treating those with long term illnesses and conditions
• What are the holistic approaches to care?

  Person-centred planning

  Person-centred care

  Maslow's Hierarchy of Needs Theory

  Advanced care planning (for example, end of life care)

  Do Not Resuscitate directive

  Integrated working
• What is the importance of using holistic approaches?

  Ensuring any care provided is in the individual's best interest

  Complying with autonomous practice

  Encouraging engagement with health and social care professionals and organisations
• What are verbal communication techniques?

  Includes:

  • Face-to-face conversations
  • Phone calls
  • Asking questions
  • Recorded messages
  • Delivering a training session or presentation
  • Interviewing someone
• What are nonverbal communication techniques?

  Includes:

  • Gestures
  • Facial expression
  • Body language

  Some special methods used by individuals with sensory impairments:

  • Makaton - simplified form of sign language
  • British Sign Language
  • PECS - picture exchange communication system
  • Braille
• What are the barriers to communication?

  Sensory disorders (e.g. speech, hearing or sight)

  Mental health conditions

  Language barriers

  Time pressures

  Noisy environment

  Positioning of the individual from the healthcare professional

  Tension or conflict
• How can you overcome barriers to communication?


  Actively listen to the individual about their communication needs/preferences

  Active involvement from the individual in how/when/where and in which way they are communication to meet their needs

  Access to information that is understandable to the particular individual

  Choice of communication aids or supports that match the needs and preferences of the individual

  Access to a range of support options and choice given to individual
• How would you apply the Mental Capacity Act (2005) plus Amendment (2019) to the provision of person-centred care?

  Begin by assuming the individual has capacity

  Support the individual to make decisions

  Recognise that unwise decisions do not mean a lack of capacity

  Decisions must be taken in individual's best interest

  Consider whether a decision can be made in a way that is less restrictive of an individual's freedom
• How would you apply the Liberty Protection Safeguards (LPS) to the provision of person-centred care?

  These safeguards only apply when:

  • the person lacks the capacity to consent to care arrangements
  • the person has a mental disorder
  • the arrangements are necessary to prevent harm for the individual
  • the arrangements are appropriate to the likelihood and severity of harm
• What are the considerations when providing person-centred care to people with pre-existing conditions or living with illness?

  Removing unnecessary barriers preventing someone with a disibility to take part in activities, access work or live independently

  Ongoing treatments

  Overall wellbeing

  Following the person-centred plan

  Co-morbidity and the impact on the individual and their family

  Assessment of need

  Discharge planning

  Mental capacity

  Individual's rights and wishes

  Access to community provision

  Access to additional secondary services

  Financial circumstances

  Carer's assessment
• How can mental health conditions, dementia and learning disabilities influence and person's needs in relation to overall care?

  Increased monitoring/support requirements:

  • physical/social support requirements (e.g. care support worker)
  • communication/behaviour support requirements
  • reduced ability to self-care

  Behavioural factors:

  • behaviour that challenges

  Comprehension factors:

  • anxiety/lack of understanding of the care
  • impaired rationality around the condition/care
  • dissociative conditions
  • awareness of possible abuse
  • refusal of treatment
  • perceived stigma attached to conditions/disabilities
• How can you promote independence and self-care?

  Encourage individuals to have involvement, choice and control over their own self-care

  Allow individuals to have access to support networks, appropriate info, a range of learning/development opportunities and understand the range of options available

  Support in risk management and risk-taking to maximise independence and choice

  Allow individuals to be supported to identify their strengths, assess their needs and gain the confidence to self-care

  Assistive technology made available to support in an individual's ability to live independently
• What is the positive impact of promoting independence and self-care on the healthcare sector?

  Improves self-esteem and independence of the individual

  Improves partnership working

  Improved efficiency of staff time within healthcare services
• What is end-of-life care?

  Care provided to those who are in the last months/years of their life

  Also refers to the care provided when the efforts made to successfully treat or control a disease has ceased
• What is palliative care?

  Relieving suffering through an approach that improves the quality of life for patients and families who are facing a progressive, life-threatening illness

  Relates to symptom management and improving the quality of life for those with a serious illness
• What is a hospice?

  A place or organisation that provides care for people who are dying
• What does expected death mean?

  The result of acute or gradual deterioration in an individual's health often due to advanced disease or terminal illness
• What does sudden/unexpected death mean?

  Death without warning (e.g. an accident, heart attack or an act of violence)
• What is grief?

  A response to loss and often described as intense sorrow

  Used in the context of having lost a person who has died
• What is bereavement?

  The sense of loss when someone close passes away
• What is the role of healthcare professionals in providing person-centred care for the individual during the active dying phase?

  Providing info on what they might expect

  Addressing questions/concerns honestly

  Taking time to actively listen

  Understanding the stages of grief and providing emotional support/advice

  Recognising when someone may be entering the last few days and hours of life

  Involving the individual and families in decisions about their care and wishes

  Involvement of multi-agency teams where required

  Advocating parents' rights and wishes

  Safeguarding the individual
• How would you support people with bereavement and how would you communication with families?

  Provide a safe and comfortable environment and resources

  Provide emotional support

  Understand families may have an emotional reaction and how to handle them

  Duty of candour (transparency)

  Acknowledgement of cultural/religious rituals with individual

  Signposting to applicable services
• What is care in the 6 C's?

  A care worker should do all they can to maintain or improve an individual's health and wellbeing