UNIT 70 LEAD PERSON CENTRED PRACTICE
DUDLEY COLLEGE LEVEL 5 COURSE WORK
1) UNDERSTAND THE THEORY AND PRINCIPLES THAT UNDERPIN PERSON CENTRED PRACTICE
1.1) Explain Person Centred Practice:
Person Centred Practice is an approach that puts the client at the centre of their care and their care is structured around their individual needs. It involves them in making decisions about things that affect them (Health Foundation 2012). It simply means the client is in the know of whatever assistance he or she is being given. The client can at any time decide what they want, how they want it and when it should be done. The client is also informed about what they are involved in, the best method for them and ways to get them better and allowed to make their decisions and choices.
The people/person assigned to each client will be able to perceive and notice what is vital and what is of high importance to the client they are assigned to work with and this give them an insight to know how to effectively care for the client and to be more comprehensive to the demand and desires of the client. In person centred practice, the patient have the authority to choose and make their decisions and participate in any treatment they require, they also have the benefit of making approval of all the processes involved in their daily lives , given them this opportunity makes them feel supported , important and gives them self dignity.
Person Centred Practice plays a major role in the care sector, it involves the client fully in planning, developing and assessing every required about their needs. In simple words we can also describe it as involving clients and their families in the heart of the decisions and both can influence the care plan to suit the individual needs. Person centred practice also put value to the dignity, respect and privacy rights of the client. Health government (2002)
1.2 Critically Review Approaches to Person Centred Practice
When talking about person centred practice the main person is the patient. Always explain what is going on with the patients, why you are doing what u do or what will happen when you do, these are questions that the service users will what to know and they should be answered. It is mandatory to make the service users feel included at all times. (Hassan, 2009). These are the following but not limited to those mentioned below.
• Always help the service user do as much for themselves i.e given them independence to help themselves and not always rely on the care worker.
• The patient comes first, in person centred practice, in that case patient have choices
• The patient must be treated as an individual in all scenarios. Some care workers make mistakes of shouting on their patients and also treating them like a child including using power to control them; this might cause the patient to go more into depression because at their recent state, they are already vulnerable.
• The patient must be treated with dignity and respect, this will open them up to achieve independence as much as possible
• Ensure that the patient rights and privacy are maintained at all times
• The patients and their families will have control over all aspects of their life, from beginning to the end and it also involves making everyday decisions of what happens to them.
1.3 Analyze the effect of legislation and policy on person centred practice
Most government continues to provide policies to enable patients to be promoted with the choice of what they want their care to be, by promoting legislations. Legislations and policies such as:
Mental capacity Act 2007
Human Rights Act 1998
Are few legislation and policies act that enforces that service users make their choices in their needs, health care and everyday life. This legislation and policies also ensure that these service users are treated with dignity and fairly at all times during the care. In some extreme cases, if the mental health of the service user is very severe and could lead to the service user causing harm to themself, then others are allowed to make decisions for them in these cases. In 2007 the mental act was implemented to protect cases like this mentioned above. At the same time any decisions made for them must be to the best of their interest and also in a positive way.
Person centred planning is implemented in some scenario by professionals in order to keep the well being and safety of the service users. But even though sometimes as mentioned above the decisions may be made for service users that lack the capacity at that point to make some important decisions, it should also never assume that they are unable to make any decisions because of the mental or physical state they are in at the time.
Department of Health (2009) is working on opening and given more opportunity for providers and introduces competition into care services. We have seen in the local south end area of the United Kingdom that there has been a collaboration in the local health surgeries which now include speech and therapy, minor operations, Audiology, blood tests, diabetes checks etc. this enables the patients to be able to go to their local surgeries instead of wasting time at the local hospital. (Department of health (2009).
1.4 Explain how Person Centred Practice informs the way in which consent is established with individuals
In person centred practice the choice of whatever the patient wants is solely in their hands, care workers and others can assist them in making decisions and keeping control of their lives. The patient must be told all the information and be able to understand the information relevant to the decisions, having in mind that the information is important and use it as a working process and to make their decisions. In the case that the patient cannot make his or her decision based on the state of the patient, then it’s advisable for the next of kin or immediate family or legal representative to make the decision on behalf of the patient. In other instances help can also come from doctors, previous care to mention few who have immense understanding about the patient, they will come together to give and assist the patient in decision making and they will seek consent from the patient to make this happen. The patient has the liberty to withdraw any consent form or letter or action when the patient feels its not benefitting their needs.
Person – centred practice may include that the individual needs an advocate or social worker to act on their behalf. They must be allowed. This will enable the patient to be treated with the values and beliefs they know. This is all arranged around the patients person centred practice and must be included in their every day care. If they are not capable of giving consent, then they must have a mental capacity assessment and their care must be centred on their best interests.
1.5 Explain how person centred practice can result in positive changes in individuals’ life
It literally means given the patient or individual control over their lives, it can be in participation , , valued roles , belonging and greater authority over decision about the way they live. They are also given genuine partnership with care provider and their families, allies and personalized support arrangement.. All these contribute in helping to get them better.meaning that the individual will have a real home., a purpose , family and friends and others . the individual will have control of the direction and future, good health , safety , security and justice.
The aim is to give the patient as much control over lives as possible. It may only be small change that is o say we have recently had a patient with START that needed warfarin administered every evening . How ever he enjoyed a large glass of port every evening and wished to go to bed early. START contacted his doctor and asked if the warfarin could be given in the morning. The doctor agreed to this. This enabled the patient to carry on with his everyday life, enjoying his glass of port at night and START ensuring he had his medication correctly everyday. Person centred practice may be on a larger scale. That is a stroke patient maybe entitled to direct payment which would enable him to conduct his own management of care and enable him to have rehab assistants and care assistants when he chose to have them. This may enable them to go shopping or to the gym or to do day centers. The choice would be the patients.
2) Be able to lead a person centred practice
• Support others to work with individuals to establish their history , preferences , wishes and needs- a team leader is responsible to work with rehab assistants and their patient to establish their personal history, all patient have their individual care plan which shows the patients medical history and care needs. The team leader monitors the rehab assistant to ensure they are abiding by the patients wishes and needs.
• Support others to work with individuals to review approaches to meet individuals’ needs and preferences.
• Support others to work with individuals to adapt approaches in response to individuals’ emerging needs or preferences- on way of reviewing approaches is by supervision. When I have supervision with the rehab assistant I ask them if there is any training that they feel they need to enable them to do their jobs properly and correctly. This improves their quality of work. Whilst carrying out their roles and it is an opportunity to see if there are alternative ways that can be tried in practice .
Person centred practise (PCP) places the individual at the centre of the care they receive and this can lead to a lot of positive changes. Before the use of PCP, treatment of an individual was based on their condition (medical model). Decisions are continually made for the individual as they are only defined as being independent once they overcome their disabilities. Taking away a person’s choices long-term may lead to ill effects such as withdrawal, depression, lack of motivation, lack of progression, delusions of over dependency, challenging behaviours, lack of opportunities and community access and institutionalisation.
Using the a social model of treatment means that individuals are defined as being independent as long as they are given the tools and help they need to do so. Empowering an individual to make decisions about their life and helping to honour those decisions means that an individual’s world has been opened up. This can lead to individuals having increased access to the real community giving them valuable and real experiences and helping to form relationships. Using the medical model means that individuals would have been held back from community access because they would be assessed as lacking independence. This may lead to individuals being ‘institutionalised’ through lack of experiences. Planning activities based on a medical model may mean individuals are guided into activities which are ‘good for’ their condition and probably involving other people with similar disabilities. However activities and therapies are far more successful if they are based on an individual’s actual interests and more likely to be spent with a wider range of people, nurturing more varied experiences and relationships.
3) Be able to lead the implementation of active participation of individuals
The main essential part of lead person practice is to include the patient as an active participant in their every day care. If the patient is not included then it is not person – centred practice. Working with start we have occupational therapist and physiotherapist who set therapy goals which are individual to each patient. They ask the patient what their goals are. This enables the patients to have a feeling of self worth and achievement when the goals are met.
3.1) Evaluate how active participation enhances the well being and quality of life of individuals.
3.2) Implement systems and processes that promote active participation
As a senior rehab assistant with start one of my roles is to implement active participation with the patients and make sure that the necessary risk assessment are done before these practices are carried out. I regurlarly monitor the rahb assistant when they are carrying out their rehab goals with the patients to ensure that lead center practice is included and that they are giving the patients a choice in their every day care and mobility aims.
Rehab assistants must not tell the patients that they need to do these goals , if they feel they do not want to do them , they must always give them a choice. If the goals that the patients asks for are too demanding for them , a compromise needs to be done to ensure that they carry out these goals safely. Systems and processes on individual patients include:
• Their personal history
• A full assessment on their abilities , needs,, wishes and preferences on a regular basis
• Asking the patient what they want from the service and how they would like to be addressed
• Respecting every patient’s culture and other personal characteristics , wheather due to ethnicity , age , gender or other criteria