305 Person Centred Values

Kayleigh Newman
Questions for Person Centred Approaches
Describe person centred approaches.
Person centred Approach is all about putting the individual’s needs, wishes, preferences and beliefs first. It’s about ensuring that they are involved in what is happening to them. It is respecting them as individuals. Upholding there rights as individuals. It’s making sure that they are in the middle of everything that you do
Explain how and why person-centred values should influence all aspects of social care work.
Person-centred is about providing care and support that is centred or focused on the individual and their needs. We are all individual and just because two people might have the same medical condition, for example, Dementia and learning disabilities, it doesn’t mean that they require the same care and support.
We need to develop a clear understanding about the individuals we are working with. This includes their needs, their culture, their means of communication, their likes and dislikes, their family and other professionals’ involvement so we can promote and provide person centred care and support.
Person-centred values provide a foundation on which we can base and build our practice. We need to understand what the values are, how we can promote them and why they are important. A value is simply what is important in the life of the person we are supporting. These are the person centred values; Individuality, rights, choices, privacy, independence, dignity, respect, partnership, equal opportunities.
Explain how finding out the history, preferences, wishes and needs of an individual contributes to their care plan.
You know the preferred method of communication, Ensure they have the correct information about activities, Challenge any preconceived ideas about how their care should be, Provide details about the individual to ensure you meet their needs
Describe ways to put person centred values into practice in a complex or sensitive situation. This is about seeing situations from the individual's point of view, listening to them and helping them to deal with them in the way that they want. For example a doctor wants to explain a complex course of treatment to an individual. Without person centred values the doctor and you would do it in the way that you thought best for the individual. With person centred values you make sure that he provides the time the individual wants and needs to take it in and ask any questions they have, that the information is provided in the form that the individual wants i.e. verbal, written, to them only so that they can inform others, to you/others so that you/they can be involved, that the individual has the opportunity to disagree with anything they hear etc.
Evaluate the use of care plans in applying person-centred values.
Care Planning is all about improving the lives of those who receive care. A person-centred approach is fundamental to achieving high quality care, both for staff who implement care plans and for service users and their families who rely upon them. The emphasis must always be on the service user as an individual, with aspects of their unique qualities helping to inform the care plans, such as their life history, likes and dislikes and experiences. Underpinning the whole philosophy of care is respect for the dignity of the service user and ensuring that their choices and human rights are always upheld. The service user must therefore play an important role in determining what goes into their care plans.
Explain the importance of monitoring an individual’s changing needs or preferences.
A person centred approach means that the individual might want to change their mind about their care. The care plan should be flexible enough to be changed in accordance with the individual's changing needs and wants. This is important so the individual feels they can change parts that they earlier agreed to, such as how much support they want, to people able to change the care plan may give them confidence to try and be more independence and also give them the comfort of knowing they can receive more care and help if ever needed.
Analyse factors that influence the capacity of an individual to express consent.
The term “consent capacity” describes an adult’s ability to understand information relevant to making an informed, voluntary decision. A wide variety of diseases, disorders, conditions, and injuries can affect a person’s ability to understand such information. Informed consent is a phrase often used in law to indicate that the consent a person gives meets certain minimum standards. In order to give informed consent, the individual concerned must have adequate reasoning faculties and be in possession of all relevant facts at the time consent is given. Impairments to reasoning and judgment which may make it impossible for someone to give informed consent include such factors as basic intellectual or emotional immaturity, high levels of stress such as PTSD or as severe mental retardation, severe mental illness, intoxication, severe sleep deprivation, Alzheimer's disease, or being in a coma.
Explain how to establish consent for an activity or action.
Verbally - explaining what you asking for consent to and why, in writing - requiring a written response, permission/acceptance/refusal, casual "Can I take your temperature?", "Would you like to take part in this activity?" etc.

Sometimes a formal response is required but at other times a nod is all that is needed.
Explain what steps to take if consent cannot be readily established A capacity assessment by a qualified professional should be carried out to see if the individual has the capacity to make decisions. These steps should be taken by professionals as stated in five principles set on in the Mental Capacity Act 2005. A presumption of capacity should not take place.
The right for people to be supported to make their own decisions is important. People must retain the right to make what might be seen as eccentric or unwise decisions. Anything done on behalf of people who do not have capacity must be in their best interests. Anything done for or on behalf of people without capacity should be the least restrictive of their basic rights and freedoms
Explain the principles of active participation.
Recognising an individual’s right to participate in the activities and relationships of everyday life as independently as possible; the individual is an active partner in their own care or support rather than a passive recipient. This definition accentuates two key principles underpinning care: the rights of the individual and the independence or autonomy of the individual.
Many people who experience health and social care, especially individuals with significant needs, are marginalised, excluded and disenfranchised. They are not given the same opportunity to have a say in how they live their lives as most other people in the general community; their choices in what they do are severely limited.
Explain how the holistic needs of an individual can be addressed by active participation.
Active participation helps the individual to feel involved, make choices and feel empowered. This can support the holistic needs of an individual, as a whole, with their intellectual, emotional and social requirements. For example. supporting an individual to make decisions/choices will help with their intellectual needs, helping the individual to decide on an activity they will enjoy or be satisfied by will help with their emotional needs, and deciding who will assist in the task or be present will support their social requirements.
Explain how to work with an individual and others to agree how active participation will be implemented.
Service users must be at the centre of active participation but all workers must be involved, and in agreement of how it will be implemented. This can happen by all workers such as, carers, nurses, doctors, occupational therapists, physiotherapists and family being involved in the care plan and making sure they ask the service user their opinion throughout the process and telling them they can change their mind at any time. Everyone needs to encourage the service user to participate and be involved at every stage.
Explain how to promote the understanding and use of active participation.
People who use services have a right to be seen as individuals with different preferences, skills and abilities. Respecting this basic right means involving them in the way their care and support is delivered. It is the key in moving from ‘doing to’ to ‘doing with’. This can happen informally with individuals or in more formal settings, such as residents’ meetings or service user groups.
Describe different approaches to support an individual to make informed choices.
A service user should be given all the information available so that they can make better decisions when it is necessary to do so, which are based on informed choices. This information may need to be informative regarding their rights, consequences of their choices/decisions and what the possible end result of their choices may be. Information presented to the service user may necessarily need to be given to them in a format which they are able to understand, for example via leaflets, contacting third parties on their behalf etc. The Carer will also need to ensure that ease of communication between the service user and the third parties that can help them as it is this communication that will lead them to making their informed choices, for example, one of these individuals may be a benefits adviser – in this instance the service user would need to understand the information that they are being provided with. If the service user directly asks for help from the Carer it is important that the Carer’s own views do not influence their decision, as again, the choice being made must be the service user’s own informed choice.

Explain the consequences of allowing the personal views of others to influence an individual’s choices.
The consequences are that the individual making the choice may make a decision that they might later regret or worse, that has a devastating impact on their life. A person should never make a decision based purely on the personal views of others but should instead gather all the available information and decide for themselves what course of action is right for them
Describe how to support an individual to question or challenge decisions concerning them that are made by others. All decisions that involve a service user’s care should be discussed, explained and given details as to how and/or why a decision was reached. Should the service user disagree with any decisions made about (or for) them by third parties they are perfectly entitled to challenge this. In this case, they may need the Carer’s knowledge and support in order to do so. The first thing for the Carer to do would be to ensure you have obtained their permission and then establish exactly what it is that they wish to challenge regarding the decision. If the challenge is in relation to an element of their care the Carer must firstly advise the service user of the company complaints procedure, and then, if needs be, assist them to complete the necessary paperwork. The Carer must also report the matter to their line manager. Should the service user wish to challenge a decision made by an external agency the Carer could look into the possibility of offering themselves to be the service users advocate if they do not feel confident/able enough to speak up for themselves.
Explain the links between identity self-image and self esteem
In order to promote a service user’s well-being it is important they are able to retain their identity. A Carer can help them to do this by ensuring their care plan takes into account their personal values, preferences, needs and wishes. By assisting a service user to make informed choices and decisions about their care, by enabling them through activities and participation and by encouraging and praising their efforts and successes, you will increase their self-esteem and feelings of well-being. Abraham Maslow developed a model which interpreted human needs. This is called Maslow’s hierarchy of needs. There are many factors which contribute to the well-being of individuals and fulfilling their basic needs leads to their well- being. The illustration below shows Maslow’s theory and how each need has to be fulfilled to reach the next level. You can relate each step to what you would do for the service user you are caring for.
Physiological – Ensure the service user has access to meals and drinks
Safety – Protect the service user by following health & safety policies in your workplace
Love and belonging – Encourage to participate in activities, share mealtimes,
Show the service user respect and dignity when caring for their needs

Analyse factors that contribute to a well-being of an individual
When caring for a service user a Carer must ensure that they (the service user) is treated with respect, dignity and shown value as a unique individual. Preferences, wishes and rights should be promoted along with trying one’s best to ensure they are able to enjoy their life – for this to happen an individual needs to valued, respected and safe in their surrounding environment. Choices should remain for the service user so that they are able to continue to enjoy their rights and independence, thus, continuing to strive for their full potential. By following the GSCC code of practice the Carer will ensure they are promoting the individual’s well-being.
Explain the importance of supporting an individual in a way that promotes their sense of identity, self-image and self-esteem.
Although Carers are there to support a service user in their independence it is important that the service user feels they are able to exercise their rights of choice and are in control of their own life. The Carer should actively encourage participation in activities and praise efforts when the opportunity arises – this will give the service user confidence in the own abilities and in turn increase their self-esteem. By considering their preference, choices, values and wishes in their day-to-day care the Carer is helping to maintain the service user’s sense of ‘self’, their own identity. Therefore, they should always be given choices in each aspect of their daily care.
Describe ways to contribute to an environment that promotes well-being.
The environment in which a service user lives is of great importance on their life quality and well-being. How the physical space within either their own home or a care home (if they live in one) is set up can help promote a sense of wellbeing. Windows with a view to an accessible outside space, good lighting, distinctive colours for different units, open shelves and cupboards inviting individuals to explore the contents, and clear signage are just some of the ways in which the environment can be used positively. Many possible changes can be identified with the help of staff, residents and relatives, and often made with little expense. The ways a Carer can contribute to an environment that promotes wellbeing are things such as: Ensuring their personal belongings are in their room. Encouraging service user to attend activities. Encourage service users to have their meals together
Explain how risk taking and risk assessment relates to rights and responsibilities
Traditionally, continuing risk assessment and risk management has been seen as an essential part of adult social care. The assessment of risk has often raised difficult questions for practitioners balancing empowerment with duty of care. The rights of adults to live independent lives and to take the risks they choose need to be weighed carefully against the likelihood of significant harm arising from the situation in question.

Relevant issues in assessing the seriousness of risk of abuse include:
Factors which could increase exposure to risk, e.g. environmental, social, financial, communication and recognition of abuse
Existence of networks and support to minimize risk
Nature, extent and length of time of abuse
Impact on the individual and on others.

A UK research review on risk perceptions and risk management strategies in adult social care found that studies tended to concentrate on risk in relation to mental capacity and competence of people with mental health problems, physical risks for older people, and competence and some positive risk taking for people with learning disabilities. Professional assumptions about the competence and capacity of people with mental health problems were found to be linked to perceptions of these people as dangerous individuals. The review also showed that both people who use services and practitioners may withhold, or be reluctant to share, risk-related information. This can leave people without support when taking the risks that are important to them, or conversely leave them ill-informed about options and choices.

Explain the importance of using agreed risk assessment processes to support choice.
Although risk taking is part of our everyday lives and is to a lesser degree a part of almost everything we do it should not exclude an individual in participating. It is essential to a service user’s safety that the service user themselves and the Carer are able to recognise, assess and manage possible risks. It is therefore the duty of the Carer during the promotion of supporting the service user’s independence to manage any associated risks and make the service user aware of these, in a way he/she will understand. Once the service user has made a choice about something that contains an element of risk a risk assessment must be carried out so as to ensure the service user is making an informed choice of whether to do this something or not. Should the risk be high it may be possible, via good communication methods, to reach a compromise based on all of the relevant information. However, ultimately the decision must lie with the service user.

Explain why risk assessments need to be regularly revised
By talking to the staff and monitoring incident rates and control measures, you will be able to judge whether the control measures are effective. Managers and staff must be given responsibility to oversee the process and develop reporting procedures, discussing and helping to implement solutions, as well as monitoring the solutions for effectiveness. Risk assessments should be reviewed regularly to ensure that the risk of staff and service users being harmed or harming themselves has not changed and that no further control measures are needed. It should also be reviewed if any changes occur that may increase the risk of violence, eg lone working, or changes in the nature of the work you do such as different types of service users coming in. There is no legal time frame for when you should review your risk assessment. It is at your discretion to decide when a review is deemed necessary, but the risk assessment is a working document and, as business experiences change, this information should be recorded and updated. As a guide, it is recommended that risk assessments be reviewed on an annual basis.
Describe different ways of applying active participation to meet individual needs
Active Participation is a way of working that recognises an individual’s right to participate in the activities and relationships of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than just a recipient. You can support individuals to make choices by giving them encouragement and giving praise when they have made a choice. This will give them the confidence to continue to make choices about other aspects of their lives. It is useful if you can support the individual to find out about local social and community networks in the areas where the individuals you support live, particularly if the people you support live in their own homes. You can support individuals to get further advice, guidance and information about what facilities are available. If an individual identifies a particular hobby or activity they wish to participate in, it might be worth checking if there are local groups or facilities that would be prepared to support the individual to participate. Being part of a community is particularly important to individuals who live on their own and do not work. It means they have relationships and make friendships with other people giving them a more fulfilling life. It doesn’t matter what kind of contribution they make or the type of activities they are involved in, just being part of something will give them a sense of belonging, a feeling of self-worth and independence.