This page contains exemplary answers for all the questions in the workbook for standard 3 of The Care Certificate – Duty of Care.
The blank workbook for standard 3 can be downloaded from the Skills for Care website (PDF format)
Further information on this standard (including all learning outcomes and assessment criteria) can found here.
As a social care or health worker, you have a duty of care to all people you support. Use the following words to define what is meant by duty of care. RESPONSIBILITY, SAFETY, OBLIGATION, WELLBEING
Duty of care is a legal and moral obligation and responsibility of a care worker to ensure the safety and wellbeing of the individuals that they care for.
Thinking about your own work role, complete the sentences below to describe how the duty of care affects you in practice. The first example has been completed for you.
My job description states that I have certain responsibilities to the individuals I provide care and support to and to my colleagues; this includes working safely and with the interests and wishes of the individual at heart.
The code of conduct means that there are a set of standards that my work must not fall below and I must not do anything (or omit to do something) that may adversely affect the safety and wellbeing of the individuals that I support, my co-workers and the wider public.
The organisational policies and procedures are there to ensure that my work complies with legal obligations, current standards and best practices, which includes protecting vulnerable individuals from harm and abuse.
I must report unsafe or abusive practices because it is a legal requirement and moral obligation to protect the safety and wellbeing of others.
There will be times when your duty to safeguard the wellbeing of the individual is in conflict with your duty to promote the individual’s right to take risks. It is your duty to ensure an individual is kept safe and does not experience harm but these situations may cause you a dilemma and you may not know the right thing to do to keep them safe at the same time as enabling them to make their own choices. Think of two dilemmas that might arise in your work and describe these in the space below
A clinically obese individual continuing to eat unhealthy foods against the advice of their GP and dietitian.
An individual refusing to wash, bath or shower.
Activity 3.2b and 3.2c
For the two dilemmas that you have described in 3.2a, complete the table below to explain what you must and must not do within your role for each dilemma and where you would get additional support and advice to help you resolve the dilemma.
|Dilemma||What you must do within your role||What you must not do within your role||Where would you get additional support and advice to resolve the dilemma and why|
|Dilemma 1||Explain to the individual why it is important to eat healthy and what the potential consequences to their health may be if they continue to eat unhealthily.|
Suggest alternatives to foods they like e.g. reduced fat burgers
|Dictate what the individual can or cannot eat providing they have the capacity to make their own decisions.||Speak to manager. Raise the issue with the individual's GP and dietitian (with the individual's consent).|
|Dilemma 2||Prompt the individual to wash/bath/shower.|
Explain the importance of good personal hygiene.
Link good personal hygiene to something that they care about e.g. getting a boyfriend/girlfriend
|Force the individual to wash/bath/shower providing they have the capacity to make their own decisions.||Speak to my manager.|
Raise the issue in a team meeting with my co-workers.
Arrange a meeting between the individual and their community nurse to explain the importance of good personal hygiene.
For each of the three examples below, describe who you would ask for advice and support in handling comments, concerns and compliments.
A number of individuals you are supporting believe that someone has been tampering with their medical records
This would be reported to my manager with the utmost urgency and escalated to senior management if my manager did not take it seriously. If the individual wished to make a formal complaint, I would support them to do so following my organisation’s complaints procedure.
You have read the complaints procedure but you would like to ask for further guidance on one section
An individual you support has told you that they wish to make a complaint about the food served at meal times
I would listen to the complaint and attempt to resolve myself or pass the feedback onto the person that prepares the meals. If the individual wanted to make a formal complaint, I would support them to do so following my organisation’s complaints procedure.
It is essential to learn from comments and complaints when providing care services. Explain the importance of learning from comments, concerns and compliments in order to improve the quality of service that you provide.
I always treat comments, concerns, compliments and complaints as a learning opportunity and a way improve my practice and the practice of others. Feedback is essential for understanding what is being done well and what could be done better and I believe it is important to use the ‘360 feedback model’ whereby information is gathered from everyone that is associated with the organisation including the clients, their family, employees, managers and professionals from external agencies.
By understanding what is done well and what can be improved, it gives the organisation the chance to rectify issues and build on good work. This is why all feedback should treated seriously and reflected upon and (in the case of complaints) investigated where necessary.
Activity 3.4a and 3.4b
You have a duty of care to respond to events and incidents in an appropriate and agreed way. To show your understanding, complete the table below to describe how you would recognise adverse events, incidents, errors and near misses (scenarios) and explain what you must not do in relation to each.
|Event||Decide whether this is an example of an adverse event, incident, error or near miss||Describe how you recognise this as an example of an adverse event, incident, error or near miss||Explain what you must do and must not do in relation to each example|
|An investigation is started after a number of patients died unexpectedly in care||Adverse event||Adverse events are actions or inactions that lead to unintended, unexpected and preventable harm. Serious adverse events are those that are life-threatening.||Must immediately inform relevant authorities e.g. CQC, Police, HSE etc.|
Must not jump to conclusions, apportion blame or try to investigate myself.
|You arrive at an individual’s home to support them with their shopping to find that a colleague has already arrived to undertake this task.||Error||An error is something that is performed incorrectly or not performed when it should have been.||Must report issue to manager to investigate what went wrong.|
Must not have a disagreement or argument with co-worker about who should perform the task.
|When serving lunch, an individual who has a nut allergy was given a peanut butter sandwich by mistake. You notice this just in time to change the sandwich.||Near miss||A near-miss is an event that could have caused harm but was prevented.||Must report this to manager. Inform the person that prepared the sandwich about the near miss. Ensure individual's care plan is up to date and allergies are clearly documented.|
Must not apportion blame or express anger.
|An individual in the bathroom area slips on the wet floor. When investigating you notice that a wet floor sign has not been used.||Incident||Incidents are unplanned negative events that cause harm or damage.||Must report to manager immediately and ensure all staff are aware of organisational procedures and health and safety responsibilities. May need to report to HSE.|
Must not apportion blame until an investigation has been completed.
Thinking about the four scenarios in 3.4a & b, list the legislation and agreed ways of working that need to be taken into account when reporting adverse events, incidents, errors and near misses.
- The Health and Safety at Work Act 1974 – responsibilities of employers and employees to ensure the health, safety and wellbeing of others
- Management of Health and Safety Regulations 1999 – procedures for recording, reporting and investigating health and safety issues
- Reporting of Injuries, Disease and Dangerous Occurrences (RIDDOR) Regulations 2013 – responsibilities to report certain incidents to the Health and Safety Executive (HSE)
- Accident Book/Procedure – Agreed way of working within my organisation to record and report accidents
Fill in the spider diagram below to list the factors and difficult situations that may cause confrontation. One example has been provided for you
Factors and difficult situations that may cause confrontation include:
- An individual with dementia may feel misunderstood, frustrated and confused
- An individual with a learning disability may not understand professional boundaries
- An individual without the mental capacity to make a decision may become upset that others are making choices on their behalf
- An individual detained in a secure hospital may become frustrated that they are not free to come and go as they please
- An individual with paranoid schizophrenia becoming agitated and aggressive because they believe that staff are making fun of them
Activity 3.5b, 3.5c and 3.5e
Thinking about the factors and difficult situations that may cause confrontation, select one that relates to your own role and answer the questions below.
1. What is the factor or difficult situation that may cause confrontation?
An individual with paranoid schizophrenia becoming agitated and aggressive because they believe that staff are making fun of them.
2. How could communication be used to solve problems and reduce the likelihood or impact of confrontation?
Explain to the individual that staff are not making fun of them and that they may be having an auditory hallucination. Say that if I had something to say to them, I would tell them to their face and not behind their back. Remind them of other times that they have believed something that turned out not to be true.
3. How would you assess and reduce the risks in this situation?
Make realistic judgement calls based on my knowledge and experience of the individual. Suggest that the individual goes with me to a quiet place (away from others) to discuss the issue and talk about how they are feeling. Offer PRN medication as a last resort.
4. What is the agreed way of working for reporting confrontation in your service?
Filling in an ABC chart and referencing it in the individual’s daily notes and the staff communications book. Reporting confrontation to manager and possibly explaining what had happened to other staff on handover.