3.3a Find out what consent model your organisation employs for personal data of people who access care and support

describe a situation where this has been put into practice

When contracting us to provide their care and support, clients are informed that staff may share their information with other professionals and/or their families as long as it is in their best interests and on a need-to-know basis. Clients can choose to sign to agree to this or not.

A client I work with had agreed to this, which meant that I was able to share details of his support plan with his social worker so that she could complete his assessment.

Describe how the situation would have been handled differently if an alternative consent model had been adopted

By having a cover-all consent model as long as it is best interests, the social worker was able to complete her assessment quickly without having to ask the client for consent multiple times.

What impact would this have had on the individual?

If the client were to be repeatedly asked for consent, this may have resulted in them becoming bored and lack motivation to complete the assessment. It could also result in them becoming upset or angry.

Conversely, if the client had not been asked for consent at all, as well as breaking the law this may have resulted in them feeling less valued, lower self-esteem and lower confidence.

compare the ethical and moral dilemmas involved in both models

Both opt-in and opt-out consent models allow the individual to make an informed choice.

3.2b Use this template to consider the effectiveness of the systems you have identified above.

What is/are the main reasons for having systems?

To ensure adherence to legislation and good practice, that confidential information is secure and correct records are kept.

Who is the information and data for?

The information is for staff, clients and the business.

Who owns the data and information?

The company owns the data

how do the systems in place meet legal and ethical requirements?

Confidential and personal information is secured and only accessible on a need-to-know basis.

reflect on the links to respect and privacy issues for the data and information in your systems

The online system only allows access on a need-to-know basis. Similarly, paper records are locked away and secured to ensure that only the relevant individuals can obtain access to them. This is covered by GDRP.

3.2a Reflect on your own information management system. For each piece of information stored complete the following grid.

 

Information Who completes/stores? Who monitors? How is it stored/secured? Who has access?
Support/care plans Managers and seniors Managers/seniors Online system Client, support staff
Personal information of people who access care and support Managers and seniors Managers and seniors Online system Client and support staff
Personal staff files HR HR Locked filing cabinet in locked office HR

Staff can ask to access their own files

Supervision/appraisal documents Managers, seniors and HR Managers and seniors Locked filing cabinet in locked office HR, managers and seniors
Statutory information, advice, guidance Registered manager, managers Registered managers, managers Online system All staff
Other

3.1b Reporting and Recording Systems

Explain the difference between subjective and objective recording

Objective recording only contains the facts, whereas subjective recording also contains the individual’s own personal thoughts, feelings and views.

From your experience, identify three consequences of inaccurate or incomplete records
  1. An appointment is missed
  2. Time is spent doing something that has already been completed by someone else
  3. Medication overdose (given twice as first administration was not recorded)
Consider why and how you might share records with people who access care and support, carers and relatives

Personal information about a client should only be shared with their consent unless not doing so would result in harm or injury to themselves or others or result in the law being broken.

Information should then only be shared in a private setting and on a need-to-know basis and should also be in the client’s best interests.

What difference might this make to the format and storage of any records?

Records should be kept and archived until no longer needed.

Provide specific examples of how you might use accurate records to support positive outcomes for people who access care and support

Showing records of a clients meals and snacks to their dietitian so that they can offer the best health advice for the individual.

Informing a pharmacist of the conditions and current medications of a client  before supporting them to buy over-the-counter medication.

 

3.1a Think of a case study of someone that you have communicated with – a staff member or someone who accesses your service. Write a brief summary of the situation/circumstances and then answer the following questions.

Brief Description of situation

A member of staff called to say that she couldn’t do her shift because she had had some major personal issues that had put her in a precarious mental state.

how did you demonstrate empathy?

I told her that I was sorry to hear about her situation and expressed that I would not know what to do myself if it had happened to me. I told her not to worry about work as family is more important and I would arrange to get her shift covered.

What difference did it make to the person?

It gave her an opportunity to offload her personal issues, made her feel like she had a sympathetic ear and made her feel less guilty about taking time off work.

how did you demonstrate active listening?

She was very upset but just having someone to listen to her seemed to help a lot. I demonstrated I was listening by repeating back to her what she had said in my own words for confirmation that I had I understood.

How did that enhance effective communication?

She became less frantic and more relaxed.

2.4a Ask your line manager(s) what regulation and inspection processes your organisation might be subject to and complete the following exercise.

 

Regulation Process Who is involved Impact on organisation Frequency Information/evidence required
e.g. RIDDOR – Reporting of injuries, diseases and dangerous occurrences regulations 2013
  • Employers
  • Registered Managers
  • Line Managers
  • Employers
  • Registered Managers
  • Line Managers
As and when incidents happen according to the RIDDOR regulations Organisations policy

RIDDOR reports needed

Accident book

CQC Inspection
  • Registered Manager
  • Line Managers
  • Employers
  • Employees
Benchmark how we are doing and how we can improve Infrequent but to be expected at any time Speaking with clients and staff

Viewing policies and procedures

Viewing other records

Internal Quality Assurance
  • Compliance Manager
  • Line Managers
Ensure we are providing support correctly and to a high standard

Highlight any areas that require improvement

Every 3-6 months Compliance checklist

Policies and procedures

Other records

2.2b KLOEs: Outline what each question might mean for your setting. Think about areas where this might apply and what evidence you may be able to provide for that. You may want to work with other members of your team or your line manager to review this plan and consider what evidence might be helpful.

 

Key lines of enquiry
Area Application in own setting Evidence
Safe Clients are protected from avoidable harm and injury? Clients are safeguarded from abuse.    Accident book, property maintenance log, recorded smoke alarm, carbon monoxide and electrical safety tests, safeguarding policy, staff safeguarding training
Effective Clients have a good quality of life and achieve good outcomes.       Speaking with clients, daily records, activity planner, meal planner, MAR sheets, support plans, well-trained staff
Caring Clients are treated with compassion, kindness, dignity and respect.      Speaking to clients, observations, well-trained staff, policies and procedures, risk assessments, support plans  
Responsive Clients needs are met and support is well-organised and flexible. Shifts based on client needs and wishes, client is able to go on regular holidays and other activities they wish to do, dialogue between staff and clients on their requirements, shifts can be changed when required, procedures and policies that provide support to staff for emergencies or unforeseen circumstances
Well led Good leadership and management. A learning culture.    Staff training and personal development, organisational charts (hierarchy), regular supervision, appraisal, observations and professional discussions, honesty and transparency, company policies and procedures.

2.2a Ask your line manager if you can put together an action plan against one of the fundamental standards where you both agree that improvement is needed. Considering standard 1, how will you lead change/inspire your colleagues – what leadership style(s) will you consider using and what procedures and audit tools will you use to monitor/manage compliance.

Take a look at CQC’s Fundamental Standards here.

In brief, they are:

  • Person-centred care
  • Dignity & respect
  • Consent
  • Safety
  • Safeguarding from abuse
  • Food & drink
  • Premises & equipment
  • Complaints
  • Good governance
  • Staffing
  • Fit & proper staff
  • Duty of candour
  • Display of ratings
Fundamental standard Dignity & Respect     
Issues When a client gets upset he likes to go to his bedroom for some quiet time to calm down. He has complained that support staff constantly disturb him to ask him how he is and if he wants anything, which aggravates him further, despite him telling them that he wants to be left alone.

There is no valid reason to disturb him if he wants to be left alone and staff should respect his privacy whenever he wants it. There is also no associated risk with him being left alone.

Speaking to staff, the reasons for their actions are to try to help the individual and because they are worried about him when he is upset.

How will you inspire colleagues? During the next team meeting, the manager will raise the concerns of the client. Staff will discuss privacy, respect and choice. They will be asked to think about what it would be like to have constant support whether they want it or not and how it would feel to not be able to experience alone time without someone disturbing them regularly.     
Leadership style(s) to use Democratic and coaching     
How will you monitor compliance? Weekly dialogue between client and manager to discuss the issue.

Client to keep a record of any disturbances to his alone time, including date, time, staff member, reason for disturbance etc. to be given to manager weekly.    

Audit tools required

 

 

Record sheet for client     

 

2.1b Choose one key piece of legislation or driver that’s relevant to your organisation and do a brief overview that could be shared with others in your organisation to enhance their learning.

 

Name of legislation Mental Capacity Act 2005   
Summary of key areas Capacity should be assumed until proven otherwise.

An individual cannot be said to lack capacity until all reasonable steps to support them to make a decision have been tried.

Making unwise decisions does not mean lack of capacity.

Decisions made on behalf of an individual must be done in their best interests.

Before a decision is made about an individual, the situation must be reviewed to check that the results cannot be achieved in a less restrictive way.

Relevance to your organisation/setting Some clients may lack capacity to make decisions in certain areas.  
What it means for your team/organisation Read Care Plans!

Assume clients have the capacity to make a decision unless it is documented that they cannot.

Actions needed to be taken by members of your team/organisation If in doubt about a client’s capacity to makes a decision, this should be raised with senior staff or management.

Staff should support clients to make informed decisions where they have been deemed to have capacity.    

Who else might need to know about this legislation – people who access care and support/carers? Clients

Client’s family and friends

Other professionals     

Who else does the legislation apply to? Everybody    

2.1a Choose three pieces of legislation that might be particularly relevant to your organisation and the setting in which you work and explore the impact in more detail

Consider the following list of legislation taken from the CQC website page referenced above. Choose three pieces of legislation that might be particularly relevant to your organisation and the setting in which you work and explore the impact in more detail using the table to record your findings.

 

Legislation Relevant sections Must have Nice to know
 Safeguarding Vulnerable Groups Act 2006  All All staff (both paid and unpaid) must have a DBS check. This is a legal responsibility of the employer.  There are two types of DBS check – one for working with vulnerable adults and another for working with children.
 Equality Act 2010  All All staff must be treated equitably and given the same opportunities. The Equality Act supercedes several other pieces of legislation including the Disability Discrimination Act, Equal Pay Act, Sex Discrimination Act etc.
 MCA Code of Practice  All Individuals should be assumed to have capacity to make decisions unless it has been proved otherwise. Making unwise decisions does not mean lack of capacity, Individuals must be assessed on a decision-by-decision basis. Individuals should be given all the support they need to make informed decisions before being assessed as lacking capacity.