Unit 207
Understand person centred approaches in adult
Social care settings
This is about treating people as individuals, and valuing them and recognising that everybody is different, also that everyone has their own needs. For example;
?  ? Treating people as individual??™s
?  ? Supporting people to access their rights
?  ? Supporting people to exercise choice
?  ? Making sure people have privacy, if they want it
?  ? Supporting people to be as independent as possible
?  ? Treating people with dignity and respect? 
?  ? Recognising that working with people is a partnership rather than a relationship controlled by professionals.
Person centred values are the centre of the care package for each individual, they are an holistic approach and the service users are involved in their person centred plan and this empowers the individual and gives them control of their life. They look at all areas of the individual??™s life such as health, social activities, dreams and aspirations. It promotes individuality, rights, choice, privacy, independence, dignity, respect and partnership.
It is important as it allows the Individual to make choices regarding their life and how care is delivered. This will boost self esteem and inform them of choices that are available and reduce the risk of abuse and harm.
I can find out by reading the care plan and also by building up a good working relationship with my service users. I can then ask them for information that will support the care team to deliver care that is centred around the service user??™s needs and preferences. A service user told me she liked going to church on Sundays and this was not on her care plan, I spoke to my manager and her care plan was updated. The service user now goes to church and enjoys meeting with friends and this is something for her to look forward to.

I must take into account the history, needs, wishes and preferences of all individuals when planning care and support. This involves asking the individuals their opinions on every aspect of their daily lives, from what time they wish to get up and have their meals, to what they want to wear and what do they wish to do during the day. Including their personal hygiene and caring needs. Support and treat all service users as individuals and with respect and dignity when considering their needs and preferences. Refer them to the care plan and if they do not agree with something on their care plan, discuss this with them and then report and record the conversation with the manager and it is arranged that the individual should be re-assessed and an updated care plan can be made out with the changes wanted by the individual.
An individual care plan is created in agreement and with the individuals consent and will have recorded lots of information regarding the individual, age, family details, likes and dislikes, health needs, culture, mental health and circumstances. The care plan will need to be reviewed frequently; due to changes in the individual??™s needs or preferences and any subsequent reviews will also be signed and agreed by the him/herself. By including the persons personal values in their care plan you are ensuring that their needs and preferences are met.
? Consent is an act of reason; the person giving consent must be of sufficient mental capacity and be in possession of all essential information in order to give valid consent. A person who is an infant, is mentally incompetent, or is under the influence of drugs is incapable of giving consent. Consent must also be free of coercion or fraud.
To ensure the service user is happy with the care and support and to ensure you are respecting their needs, preferences, culture etc. If I gave a service user bacon to eat and they were Muslim this would be discrimination and could affect the service users self esteem. It is a general principle that valid consent must be obtained for a person before starting treatment or physical investigation, or providing personal care. This principle reflects individual??™s right to determine what happens to their own bodies, and is a fundamental part of good practice. For consent to be valid, it must be given voluntarily and freely, without pressure or undue influence being exerted on the person either to accept or refuse treatment. The consent must be given by an appropriately informed person who has the capacity to consent to the intervention in question.

When caring for individuals the care worker will need their consent with regards various aspects of that care on a daily basis. In order for consent to be gained the care worker will need to present all the available details and information and the choices, in order that the individual is able to reach an informed decision.
If an adult with capacity makes a voluntary and appropriately informed decision to refuse treatment and or care, this decision must be respected, except in certain circumstances as defined by the Mental Health Act 1983. This is the case even where this may result in the death of the person and/or the death of an unborn child, whatever the stage of the pregnancy. Legally, a competent adult can either give or refuse consent to care, even if that refusal may result in harm to them. You must respect their refusal just as much as you would their consent. It is important that the person is fully informed with regards the consequences of their refusal e.g. medication has been refused. If you are unable to gain consent for any reason you should inform your manager and record their refusal. Your Manager will decide if other health care officials need to be contacted e.g. doctor.
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 a passive recipient. Active participation treats the person as an individual, allowing the service user to actively participate in the decision making regarding his/her own care, activities and relationships of everyday life as independently as possible. In active participation the individual has as an active part in their own care, rather than just being a recipient, this promotes and protects their independence and rights.

It involves the individuals in making decisions about their lives. Active participation contributes to better health outcomes and the quality of care being delivered. Giving the individual the choice of what to wear, what to eat, when and where to eat it; what the individual would like to do as an activity either with company or by him/herself. This promotes independence, inclusion and autonomy and benefits the individuals by increasing their activity levels and encourages involvement in what directly concerns their life. Being fully involved in these tasks enhances the individual??™s wellbeing, increases self-confidence, self-esteem and self-belief.

Some examples of barriers to active participation and how to reduce them:
1 ??“ The carers:
Lack of knowledge/Know How
How to reduce:
Training, workshops, courses, etc.
2 ??“ Physical disabilities
How to reduce:
Specialised equipment like hoists, frames, etc.
3 ??“ Mental Illness:
Dementia, Learning disabilities
How to reduce:
Providing support to the service user keeping in mind what they can and can??™t do, being able to match the support they need, and making it person-centred.
Make sure the individual feels comfortable in his/her environment; Have group discussions where all can take part, list the results where they can be seen, that way the individuals will feel part of the event. Encourage, praise, give constructive feedback, never dismiss an idea or belittle a suggestion, even a wrong suggestion may help to bring the thought/idea in-line; treat everybody as an equal, while remembering that not everybody is the same. Providing support to the individual keeping in mind what they can and can??™t do, being able to match the support they need, and making it person-centred and still promoting independence. Some people might just need to be asked or having the activities prompted, while others may need you to show and guide them in order to actively participate in activities, and always let them know they are doing fine.
Presenting all the information to the individual in a format he/she will understand. Ensuring ease of communication between the person and those who can help them make informed choices, for example: interpreters, Nurses and family.

Person centred care puts the individual at the centre of everything, it looks at what the individual can do and identifies what they want to achieve. Sometimes the things that people may want to achieve will involve risks, which is not a problem as everyone is entitled to take risks. We all take risks in everyday tasks. Taking risks is part of being able to choose and being in control of your life. So you need to ensure that concern about risks is not getting in the way of people living their lives in a way they want to. Often, a risk assessment can make it possible for someone to do something that may seem unlikely in the first instance. Risk taking is part of developing ?  independence. If people never take risks they will never find out what they are able to achieve and work out what their limits are.

Agreed risk assessments are in place to ensure the work environment and the individuals are safe and it is part of the carer??™s job role to ensure that it is followed at all times. A risk assessment identifies the hazard and decides on precautions. Service users can take risks and it is the carer??™s role to explain the consequences of the risk and try to come to a compromise. The risk assessment allows the individual to take the risks in a more sheltered way.
My beliefs and personal views are mine alone and I would not want someone trying to influence me and it would be wrong of me to try and influence the individual. I should respect their wishes and preferences at all times to allow them to make their own choices about the care they receive and their life.
Decisions made regarding an individual??™s care should be fully discussed and explained detailing why and how the decision was reached. If the individuals aren??™t happy with decisions made for them by others, they are able to challenge this. They may need your support and knowledge in order to do this. First, you must obtain their permission and establish exactly what they wish to challenge regards the decision. If they wish to challenge a decision regarding their care, you should advise the individual of the complaints procedure and assist them to complete any necessary paperwork. You should also refer the matter to your Manager. If they wish to challenge a decision made by an outside agency you could offer to be the individual??™s advocate, if they don??™t feel confident enough to speak for themselves.

You should encourage individuals to participate in all types of activities and tell them how well they are doing. It could be a simple thing like brushing their own hair or choosing their own clothes. It could be supporting them to learn a new skill such as going on the internet and finding old friends. You could find out a local mobile beautician and arrange a pamper day or spend a day in the garden planting baskets. Always be positive around the individuals and listen to what they have to say. Everyone has a story to tell and there is nothing more pleasing than passing them on. An individual with a strong sense of identity/self is less likely to engage into situations he/she doesn??™t want to tolerate, when he/she feels these situations have a negative effect on him/her. On the other hand someone without a strong sense of self could easily be drawn into the same negative situations without saying a word and this could lead them into depression, withdrawal, etc. People with low self-esteem have negative thoughts about themselves and behave in a way that may cause others to see them in a negative way which can reinforce this low opinion of themselves. They find coping with life situations harder, some people may feel they are unimportant and that aren??™t worth the help they are being given which makes the process of promoting their wellbeing harder. When someone has a healthy self-esteem, they will easily engage into activities they are prompted with, they easily acknowledge the help provided is beneficial. They understand and adapt to changes easily, they cope better with the stress of their conditions and are more positive about their life.
Well being can be spiritual, emotional, cultural, religious, social, political, sexual, physical or mental. Ensuring systems are in place for assessing and monitoring the mental wellbeing of the individual using the service so that any areas for improvement can be identified and that anything threatening their wellbeing can be more easily addressed and resolved. Being caring, listening to what the individual has to say about his choices, opinions, always being understanding and supportive, giving feedback by asking questions and giving encouragement, making sure the individual knows he has somebody he can trust. If carers deliver the care to the individuals following the care plan this will give them a sense of empowerment because they have been involved in the decisions made about their care.
Being professional at all times and provide quality care; Working as a team and make sure the environment is clean, safe and a nice place to be. Discussing with the individuals and find out what they would like to do and discuss this with colleagues, how it can be achieved. Talk to them about their family members, showing interest. Suggest a good day centre, etc.

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