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1.3 Describe ways that healthcare services should make ‘reasonable adjustments’ to ensure that they provide equal access to individuals with a learning disability

A boy in a wheelchair with a nurse

There are many ways that healthcare services can make reasonable adjustments to make equal accessibility available to individuals with learning disabilities.

For example, organisations can ensure that their signposts are clear and easy to follow. Similarly, handouts such as leaflets and information sheets may need to be adjusted so that people with learning disabilities are able to understand them. This could be by using visual aids, using ‘plain english’/’easy read’ or providing alternative media formats such as CDs and DVDs.

Sites of healthcare services should ensure that they are accessible for people with physical disabilities. Simple changes like widening doorways so that a wheelchair can fit through or using automatic doors so that people do not need strength and stability to push/pull a door open can make a real difference.

Some individuals may need extra time to have information explained to them or may require home visits.

Carers of people with learning disabilities should be embraced as they will know how best to communicate with the individual, however conversation and questions should be directed at the individual themselves as they are the ones receiving the healthcare.

Medical records should keep a log of the individuals preferences so that the healthcare professional has the information they require to meet the individual’s personal needs during appointments.

1.2 Identify legislation which supports a rights-based approach to accessing healthcare

Legislation word cloud

The most obvious piece of legislation that supports a rights-based approach to accessing healthcare is the Human Rights Act 1998.

This defines the fundamental rights and freedoms that all individuals are entitled to, whether they have a disability or not. Each right is an article and they are collectively known as the Convention Rights.

  • Article 2: Right to life
  • Article 3: Freedom from torture and inhuman or degrading treatment
  • Article 4: Freedom from slavery and forced labour
  • Article 5: Right to liberty and security
  • Article 6: Right to fair trial
  • Article 7: No punishment without law
  • Article 8: Respect for your private and family life, home and correspondence
  • Article 9: Freedom of thought, belief and religion
  • Article 10: Freedom of expression
  • Article 11: Freedom of assembly and association
  • Article 12: Right to marry and start a family
  • Article 14: Protection from discrimination in respect of these rights and freedoms
  • Protocol 1, Article 1: Right to peaceful enjoyment of your property
  • Protocol 1, Article 2: Right to education
  • Protocol 1, Article 3: Right to participate in free elections
  • Protocol 13, Article 1: Abolition of the death penalty

NOTE: Articles 1 and 13 are excluded as they are fulfilled with the creation of the Human Rights Act.

The Equality Act 2010 makes it unlawful for individuals to be discriminated based on certain ‘protected’ characteristics of which one is disability. This means that healthcare providers must reasonably make healthcare accessible to people with learning disabilities.

 

1.1 Outline what is meant by a rights-based approach to accessing healthcare

Human Rights-Based Approach

A rights-based approach to accessing healthcare in relation to individuals with learning disabilities brings that person’s basic human rights to the forefront of the healthcare they receive.

Individuals with learning disabilities are first and foremost individuals and have the same needs and rights regarding healthcare as those without learning disabilities.

Therefore they should be implicit in their own healthcare and empowered to make their own decisions whilst being provided with information through media that they can digest and fully understand.

Healthcare providers should have well-trained staff that involve individuals with learning disabilities. When talking about an individual’s health they should speak to the individual rather than their family or support worker. They should presume that the individual has the capacity to make their own choices and discussions of sexual health should not be stigmatized.

In addition, individuals with learning disabilities should not be discriminated against and should be offered equal opportunities to access healthcare.

1.1 Define Person Centred Values

A brightly coloured individual on a pedestal surrounded by a ring of other individuals representing a definition of person centred values

The Social Care Institute for Excellence (SCIE) defines person-centred values as:

Promoting person-centred values means carrying out your role in a way that respects the people you work with so that they can live the life that they choose to.

Essentially, person-centred values are values that have the individual at the core. In an adult health and social care setting, the individual would be the adult that is being supported.

The individual should be considered an expert adviser in the management of their support plan – no-one knows or understands their particular needs, desires, likes, preferences, wishes etc. more than they do themselves!

Sometimes, particularly in the past, care packages have been put together out of convenience by the provider and without the collaboration of the individuals who receive the support. However, this can lead to care packages that are not suitable for the individual – even the most well-meaning care worker can get it wrong if they do not consult with individual.

Old-fashioned views and opinions consider that individuals with learning disabilities, mental health conditions, dementia and other illnesses that affect cognition are unable to make sound choices for themselves and that others are needed to make decisions on their behalf be it family, social workers, care workers etc. Whilst there are still cases where others must act in the best interest of individuals (for example, if an individual is detained under the mental health act), on the whole most individuals are fully capable of making their own choices. And it is against the law for care workers to take away this right (see the Human Rights Act for further information).

Person-centred values are also about treating individuals with dignity and respect. Part of this, as stated above, is not restricting individuals from making their own choices (even if you do not agree with them yourself) but also encompasses communication, seeking consent, privacy and independence.

By working with person-centred values at the forefront of your practice, you can give the individuals you work with a better quality of life and help them to establish their own identity and raise their self-esteem.

1.3 Explain Why It Is Important To Observe An Individual’s Reactions When Communicating With Them

Observe and respond to an individual's reactions when communicating - Care Certificate - DSDWEB.

It is important to observe an individual’s reactions when communicating with them as there may be visual cues about their understanding and feelings that they are unable or unwilling to verbalise. Being mindful of these reactions can help you to communicate effectively, demonstrate that you are are listening, keep the conversation flowing and prevent misunderstandings.

For example, if the individual is nodding whilst you are speaking, and clarifying what you say, it probably means that they are listening and attentive and you should continue. If the individual looks confused, it may indicate that they do not understand and you may need to rephrase what you are saying in different words. If they are avoiding eye contact and looking in the opposite direction it may mean that they don’t like what you are saying or aren’t interested, so you may need to try a different approach or try again later.

Some reactions may be related to the environment or the situation and have no bearing on what you are communicating at all. Therefore, it is important to do your best to make an individual as comfortable as possible before the conversation starts to ensure they are receptive as possible to what you are saying.

Environmental factors can include:

  • Temperature
  • Lighting
  • Seating

And situational factors can include:

  • Unexpected meeting
  • Conversing immediately after a behaviour
  • Tiredness

You may be able to identify the reasons for an individual’s discomfort by observing them during conversation. For example if they are shivering it could indicate that they are cold and you can offer them a blanket or turn the heating up. Or if they seem tired and unresponsive it may tell you that they should get some rest and the conversation should be rescheduled.

In summary, without observing the person you are communicating with, it will be very difficult to identify and remove barriers to the communication and tell whether they have understood you correctly.

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