Good practice: adults

Good practice openhandedsGood Practice Adults This identification pass on focus on a fountain from practice, demonstrating the challenges in promoting freedom specifically in vulnerable olden adults while balancing adventure and autonomy. Further more than, this course will demonstrate problem solving skills, drawing on legislation, research and principles of good practice in the context of Adult work from an inter-professional perspective.The De givement Of wellness defines a vulnerable person as person who is or whitethorn be in penury of corporation do by benefits by reason of genial or other(a) disability, bestride or illness and who is or may be unable to tax return handle of him or herself against probatory harm or exploitation. (DOH 1999).Background of caseMrs A is eighty dickens forms old, has mild encyclopaedism difficulties and buy the farms totally in her own base since the death of her husband mavin family ago. She has a young lady who visits oc casionally due to their difficult relationship. Mrs A was referred by her GP as she had been sprightlinessing unwell for some time she has diabetes and sometimes forgets to take her medication. Mrs A has refused help in the past by diverse finagle go due to lack of trust and sees their involvement as an intrusion in her private life. hightail iting indoors the field of the olden in adult societal inspection and repairs is described as gerontological Social go (Nathanson and Tirrito 1998). There ar specifics needs that elder the great unwashed work done, the more informed a societal worker is ab bulge the elderly and their requirements the better chances are that the kind worker will provide the ripe(p) supporters.It is essential to gain a clear infrastanding of economic, complaisant and heathenish factors and life perspective followed by an understanding of the need for service.The Valuing People polity is the first egg white Paper in al just about forty r ecollective time since Better Services for the Mentally Handicapped (1971).The aim then was to soused large institutions and to integrate raft into the community (www.mind.org.uk). Valuing People aimed to transform the lives of adults and children with learning disabilities through a person-centred onset and to enable raft to become authorise in order for them to be accommodated in society. This insurance is oneness in a series of policies that are an example of the political number one wood of change such as the White Paper, Our health, Our dread, Our Say A impertinently Direction for Community Services (2006) that are aiming to transform accessible dish by and to give service users more choice and to make the trunk more personalised (Johnson Williams, 2007).The 1989 White Paper, Caring for People states the duties of topical anaesthetic health administration to assess state needing social attending and/or keep. It is based on the assumption that community a pportion is the best form of oversee in stock(predicate). The White Paper states that the proposed changes are intended to, first of all, enable hatful to live as normal a life as possible in their own home(a)s or in a homely environment within the community. This is especially all important(predicate) in the long-term needs of the elderly, whom realise long expressed their wish to be able to stay in their homes. Furthermore, local authorities must provide the right amount of care and instigate to enable mint to achieve maximum freedom and provide people with a greater say in their lives and the service they need. This is particularly signifi coffin nailt with elderly people. Many senior people are non in need of 24-hour care that a nursing home would provide they may just need a small amount of help, maybe for a couple of hours a day. Although the majority of people over the age of 65 live independently and carry no major care needs, a signifi placet minority do have so me problems with physical and mental health. 1 in 10 elderly people suffer from forms of crazy dementia. It john be seen that it is simple day-to-day things that most elderly people require assistance with. Their main wish is clear they simply motive to stay in their own homes or in the homes of their family. (HMSO 1989).The Social player requires Mrs As consent to an assessment and if eligible, a care plan, while reservation it clear that she has the right to refuse. When works in partnership with a service user and their family, the worker needs to take account of Trevthicks (2002) fifteen points to sound partnership functional. These include explaining to the family their role and power to intervene. A clear statute is the basis of a partnership-based intervention and sensitivity given to power imbalances involving family mention and participation in decision-making and problem solving (Bray 2001). The whole team working with Mrs A have a business to be aware of her so meone rights to confidentiality, choice, dignity, respect, autonomy, cultural, and equity. Elderly people need to be sprightly participants kinda than active recipients. The task is not to look after, but to motivate, empower and promote self-esteem. (Hughes et al 1995).A number of vulnerable adults are oblivious to the fact that they need any help whence it is essential that when a concern is gameylighted, it is acted upon straight off to prevent the situation deteriorating. Many adults are in like manner too uplifted to ask for help and as a result recognition of their pic is only identified as shown in Mrs As case by a GP. Detection of vulnerability may also be triggered by an admission to hospital or a concernedfriend or family member contacting the social service department. During a visit by the social worker, it is clear that Mrs A had been seriously inattentioning her needs she is underweight and neglecting her hygiene. The misuse of medication is in itself a try o f covert self abuse, and could have resulted in her death. Abuse can take place in umteen an(prenominal) different contexts and it is important not to exploit a vulnerable persons civil rights. Mrs A has mistrust with other people becoming involved in her life. Therefore when and how to intervene builds on the concept of significant harm introduced in the Childrens bear. When making an assessment of an individual, many factors need to be considered, for example, the extent of vulnerability and take a chance of repeated acts that seemly the criteria of the Community bursting charge Act 1990. To ignore the assessment of older people can be an example of ageism in its own right, modify to an elderly person feeling disempowered.Assumptions roughly older people include older people are poor, lonely, are ill, no longer contribute to the economy and seen as a burden. When working with older people it is important not to make these stereotypical assumptions and generalise. Not all the elderly have the same characteristics a sixty five and a ninety year old are classed as one group. Although aging is inevitable, and people experience similar patterns and problems of aging, in that respect are also wide-spread differences in aging patterns (Applewhite 19985). Ac spotledging that severally individual will be at a different distributor point in his or her life, needs and circumstances will vary, including different heathen minority groups to avoid making ageist assumptions and avoiding all stereotypes and stigmas. To work effectively with older people, one must develop anti ageist practice. Midwinter (1993) says that old age is want having returned to a second childhood where others will make decisions for you. Working in partnership, the Social Worker and the GP/nurse may get along Mrs A to engage respite care (enablement) for up to six weeks to avoid creation admitted to hospital. During respite care an assessment of her needs will evaluate the take of support that will be required (if any) when Mrs A returns to her home. Mrs As daughter may request that her mother be put into a care home, while Mrs A is adamant that she can care for herself at home with some support. Within the risk assessment process family members may invade ab bulge the social workers ability to recognize potency risk for their relatives, therefore a balance between extending barriers in some areas of risk and minimizing risk in others areas needs to be do. Using a utilitarian get along, it is the social workers job to assess the whole situation and work for a solvent in the best interests of all concerned. (Banks 200128). The Social Workers ultimate aim is to support Mrs As rights to control her life and make informed choices about the services that she receives (GSCC 1.1).Good practice dictates working in partnership with service users to encourage greater trust and empowerment of clients. In turn, they are likely to feel more confident in talking about their fears, and worries and possible abuse. health and Social care agencies working together is only a part of an overall strategy to protect vulnerable adults from abuse. Enabling service users to make do abuse and knowing how to alert others to this is another strategy. It also ensures an agreed approach that all involved are aware of and can monitor. vindication is provided by the clarity of the situation. It is important that health and care social workers act as good role models in terms of worker-user relationships as this helps the service user to recognise when the relationship is abusive. In addition, it is important for professionals to enable service users to know how to protect themselves, such as building positive self-esteem through knowing their rights and knowing how to complain. (Public interest Disclosure Act 1998).An Adult Protection insurance policy will identify and help support Mrs As decisions for her care and help her to understand risks and the servic es available to her. The social worker has to forever and a day question their own judgement and ensure they listen to the service users trip up while assessing if Mrs A is capable of making an informed choice victorious into account her rights and the needs of her family. It is a requirement to assess if Mrs A has the dexterity to make her own decisions and if she is incapable by reason, for instance, of mental illness under the Mental Capacity Act 2005, the decision will be made for her. If it is deemed that Mrs A has capacity she has the right to live in whatever track she chooses should her choice includes staying at home without help from services her health could be at risk and she may enter a revolving door policy in and out of health care pro wad. Providing support to Mrs A does not eliminate her susceptibility. If an individual is subsisting alone and receiving services to support their needs, they take over have a level of vulnerability. Elderly people at home are m ore at risk from abuse by strangers than if they were living in supported accommodation. They are at risk from people job and gaining access through force or intimidation, who either steal from them or charge very expensive rates for minor repairs. They are also at risk from physical and sexual abuse as there is no one there to stop the perpetrator. Mrs A has health and social care needs and is seen to be at risk from self-neglect and possibly neglect by others, including services if insufficient or inappropriate support is provided to adequately support her well being. (Pritchard, J 2008).Home may be Mrs As choice, however the assessment will consider balancing risk and autonomy. The social worker can identify Mrs As strengths and skills and identify ways in which these can be improved upon. There are services available that can supply security systems to protect from theft, and physical abuse, and other environmental variables, these are implemented with clear guidelines and the coordination of multi situation workers, working together to endure a programme of care in the best interest of Mrs As needs and individual choices. Parsloe (1999) stresses that there is a strong presumption that older people should exercise choice and be given opportunities to take risks towards maintaining their license and self-determination unless or until their capacity to do so is seriously impaired. This feeling is acceptable, but as seen with Mrs A there is also a high risk of illness due to poor self medication this is sometimes overlooked as the risk-taking model is more promoted than risk minimisation. People are allowed to take a well-informed risk so long as they do not endanger themselves or others GSCC (2002). A presumption in this case is that Mrs A has capacity the challenge here is to recognise that service users have the right to take risks and helping them to identify and manage potential and actual risks to themselves and others (GSCC 4.1). The provision of the practice setting is governed by law which consists of primary(a) and secondary legislation together with governing body guidance which must be followed by all local authorities. Section 46 of the National health Service and Community Care Act (1990) sets out community care plans and lists the available services which include laundry services, meals on wheels, social work support and residential care. This act places a barter under branch 47 on social workers to conduct a needs-led assessment if it is presumable that a person might need community care service. one time a community care assessment is carried out, the care manager will make a decision about whether to provide support or not to the service user. Fair Access to Care Services (FACS) provides an eligibility role model for adult social care to identify whether or not the duty to provide services is triggered. Should the criteria be met, a multi disciplinary team approach working together to ensure Mrs As choice t o stay at home is paramount with regard to her rehabilitation and care plan. The team have a duty to provide a network of support that promotes independence and to monitor Mrs As ability to care for herself in the community. Multi-agency working of care planning and the single assessment process has encouraged greater inter-agency working together, with the clients needs being central to the process. Rather than working separately, and each agency providing their own service without reference to the others, joint working encourages a communion of approach and less replication of services. A pilot of Individual Budgets was introduced for two years in 2005 to 13 local authorities. Individual Budgets is a system that brings resources together from different funding streams into a single sum that can be spent flexibly in accordance with a service users needs and optences. Service users are free to choose the money as a direct payment or request the local office to provide services, o r even use a mixture of two A care worker can be sought from the LA or a personal assistant (PA) appointed by Mrs A , paid for with direct payments ensure that her autonomy and choice is maintained. In practice, an understanding can be made to review Mrs As care and pip the care if it not required or increase the care case should additional need be identified at a future review.Direct payment stems from the four principles of Valuing People that are rights, inclusion, choice and independence. The Governments vision was that the uptake of direct payments would give people more choice in how they choose to live their lives. However, the uptake of direct payments since the introduction of the Community Care (Direct Payments) Act (1997) had been slow, mainly due to a lack of awareness and people, including professionals, can be very wary of change and taking on the unknown.The government therefore introduced new legislation in 2003 to make it a duty for local authorities to offer d irect payments (www.dh.gov.uk), but figures (2006) reveal that out of a possible million people only around 46,000 had taken up direct payments (www.eastern.csip.org.uk). It raised issues that service users experienced and set out eleven objectives which included people facing lack of choice and control, social isolation, housing, health, and poor partnership between professional agencies, voluntary groups and families. The main stakeholders from the carrying out of Valuing People are people with learning disabilities themselves and their families/carers, as they were instrumental in pushing the government to push through the policy.The government is clearly one of the main stakeholders and it could be argued that this was an economic driver of change. Latest figures from the Individual Budgets fly study reveal that the costs of people using budgets compared to commissioned services is not much different, but long-term, costs will be cut as people become more independent and the ir support hours are reduced (www.dh.gov.uk). The introduction of Putting People First, published by the DH in December 2007is a shared vision and commitment to the transformation of adult social care over a period of three years. appoint elements are prevention, early intervention and re-enablement, personalisation, information, advice and advocacy. This presents change for people who receive services and importantly for social care workers that will need to implement these changes in their work. The changes in social care that have been taking place since the policy have meant that the role of the social worker is changing and the publication of the local Authority Circular Transforming Social Care (20084) described the role of the social worker as being focused on advocacy and brokerage, rather than assessment and gate keeping. This involves improved skills in listening, working in partnership with service users, families and other professionals and empowering people to take co ntrol of their lives. The changes are proving challenging because it means a shift in the balance of power and allowing people to take more risks. A person-centred approach to supporting Mrs A is the method used within this case study, before direct payments this had been more about supporting people in the community.The principles ofrights, inclusion, choice and independence set out as the vision in Valuing People have clearly been achieved in some peoples lives, and is effective for service users such as Mrs A who prefer to maintain their privacy at home and choice of care through direct payment. It can be seen to transform service users lives in that they are living independently and feel included in society.There are many people living in residential care they spend most of their hours in centres and lead very oppressive lives.McCabe,M. (200612) describes the failings of institutional care as having inflexible routine, lack of choice, dependence on others and lack of privacy an d community care creating maximum dependency.However, care needs to be taken so that people are still supported when they do live independently, specifically service users who have spent years in residential care and not prepared them to live in their own homes adequate risk assessments are needed to address any areas that could leave them vulnerable. ReferencesApplewhite, S. (1998) Elders and the Twenty-First Century. Issues andChallenges for culturally Competent Research and Practice.New York Haworth.Banks, S. (2001). Ethics and Values in Social Work 2nd ed. Basingstoke, Hampshire Palgrave Publishers. Department of Health (2001) Valuing People. London Department of Health.Department of Health (2001) National service framework for older people. 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