Cover
Title Page
Preface
1. The chapters
2. What’s in a name?
3. Reference
Acknowledgements
How to use your textbook
Chapter 1: Health and social care provision in the UK
1. Introduction
2. An historical view
3. The NHS in the four countries
4. Provision of services
5. Regulation and monitoring of services
6. Professional regulation
7. Primary care services
8. Secondary care services
9. Tertiary care services
10. Ambulance trusts
11. Mental health trusts
12. Community health services
13. Social care and support
14. Assessment of care needs
15. Assessment of health needs
16. Chapter summary
Chapter 2: Working with others, teamwork
1. Introduction
2. Teamworking
3. Teams and teamworking
4. Team dynamics
5. Barriers to effective teamworking
6. Conflict
7. Chapter summary
Chapter 3: Understanding your role
1. Introduction
2. Who are you?
3. Job description
4. Agreed ways of working
5. Policies and procedures
6. Codes of conduct
7. Responsibility
8. Accountability
9. Delegation
10. Relationships
11. Chapter summary
Chapter 4: Your personal development
1. Introduction
2. Lifelong learning
3. How learning takes place, learning styles
4. Strategies to help with learning
5. Personal development plans
6. Appraisal
7. Your personal development plan
8. The personal development portfolio
9. Supervision
10. Training and development
11. Core learning
12. Giving and receiving feedback
13. Chapter summary
Chapter 5: Duty of care
1. Introduction
2. Duty of care
3. Your duty of care
4. Concerns
5. Promoting independence
6. Providing information
7. The constitution, complaints, comments and compliments
8. Raising concerns
9. Untoward incidents
10. Negligence
11. Conflict
12. Responding to conflict
13. Chapter summary
Chapter 6: Equality and diversity
1. Introduction
2. Legislation
3. Equality duty
4. Human Rights Act
5. Defining terms
6. Labelling, stereotyping and prejudice
7. Inequality
8. People with learning disabilities and those with mental health problems
9. Cultural sensitivity
10. Chapter summary
Chapter 7: Working in a person‐centred way
1. Introduction
2. Working in a person‐centred way
3. Person‐centred values
4. Enabling
5. Coordinated care
6. Personalised care
7. Person‐centred planning
8. Supporting people
9. Advanced care planning
10. The environment of care
11. Minimising discomfort, distress or pain
12. Responding to a person’s discomfort
13. Self‐esteem
14. Personal identity
15. Promoting wellbeing, identity and self‐esteem
16. Chapter summary
Chapter 8: Communication
1. Introduction
2. Care, compassion and communication
3. Communication
4. Types of communication
5. Verbal communication
6. Non‐verbal communication
7. Working in teams
8. Communication and language needs
9. Communication aids
10. Barriers to effective communication
11. Strategies to reduce barriers to communication
12. Preserving confidentiality
13. Chapter summary
Chapter 9: Privacy and dignity
1. Introduction
2. Protecting information
3. Disclosure
4. Implementing respect, privacy and dignity
5. Informed choice and choosing options
6. Assessing risk
7. Equality and diversity
8. Promoting independence
9. Chapter summary
Chapter 10: Fluids and nutrition
1. Introduction
2. Food and drink safety
3. Protecting people
4. Personal protective equipment in food hygiene
5. Nutrition and hydration
6. The Eatwell plate
7. Hydration
8. Poor hydration and nutrition
9. Helping people with their nutrition and hydration
10. Chapter summary
Chapter 11: Awareness of mental health, dementia and learning disability
1. Introduction
2. Mental health conditions
3. Service provision
4. Depression
5. Anxiety
6. Bipolar disorder
7. Psychosis
8. Dementia
9. Learning disabilities
10. The social model of disability
11. Assessing and making a diagnosis
12. Mental capacity
13. Assessing capacity
14. Chapter summary
Chapter 12: Safeguarding adults
1. Introduction
2. Safeguarding
3. Types of harm and abuse
4. Safeguarding vulnerable adults: the principles
5. A person‐centred approach
6. Safeguarding Adults Boards
7. Identifying and managing risk
8. Suspected or disclosed abuse
9. Reporting concerns
10. Chapter summary
Chapter 13: Safeguarding children
1. Introduction
2. Safeguarding and welfare
3. Child abuse and maltreatment
4. Impact of parents or carers on a child’s health and wellbeing
5. Types of abuse
6. Physical abuse
7. Emotional abuse
8. Sexual abuse
9. Neglect
10. Radicalisation
11. Trafficking
12. Female genital mutilation (FGM)
13. Gang abuse
14. Children and social media
15. The rights of the child
16. What to do if you have concerns of suspected or alleged abuse
17. Escalating concerns
18. Chapter summary
Chapter 14: Basic life support
1. Introduction
2. The heart
3. The lungs
4. Basic life support
5. The AVPU scale for checking a response
6. Cardiopulmonary resuscitation (CPR)
7. Airway obstruction
8. Documentation
9. Automatic external defibrillators
10. Chapter summary
Chapter 15: Health and safety
1. Introduction
2. The law
3. Health and safety policies
4. Hazards in the workplace
5. Workplace hazards
6. Working with hazardous substances
7. Reporting health and safety hazards
8. Risk assessment
9. Accidents and incidents
10. Medicines
11. Moving, handling and assisting
12. Fire safety awareness
13. Working safely
14. Managing stress
15. Chapter summary
Chapter 16: Handling information
1. Introduction
2. Key legislation
3. The electronic patient record
4. Making concerns known
5. The use of social media
6. Chapter summary
Chapter 17: Infection prevention and control
1. Introduction
2. Roles and responsibilities
3. Transmission of infection
4. The chain of infection
5. Breaking the chain
6. Safe disposal of waste
7. Sharps disposal
8. Safe management of laundry
9. Personal protective equipment (PPE)
10. Chapter summary
Chapter 18: Questions you always wanted to ask
1. Introduction
2. Chapter summary
Annotated bibliography
Index
End User License Agreement

List of Tables

Chapter 01
1. Table 1.1 NHS values and the NHS constitution
2. Table 1.2 UK professional regulators
3. Table 1.3 Some professionals who deliver primary care
4. Table 1.4 The care plan
Chapter 02
1. Table 2.1 Teamworking
2. Table 2.2 Some barriers to effective teamworking
Chapter 03
1. Table 3.1 Considerations prior to delegating
2. Table 3.2 Strategies that can help you to maintain professional boundaries
Chapter 04
1. Table 4.1 Some examples of evidence that can be included in a personal development portfolio
2. Table 4.2 The appraisal checklist
3. Table 4.3 Some training and development opportunities
4. Table 4.4 Some of the principles of helpful feedback
Chapter 05
1. Table 5.1 Events, errors, near misses and incidents
2. Table 5.2 Some tips on how to manage conflict
Chapter 06
1. Table 6.1 Some elements of legislation that impact on the role and function of the health and care worker
2. Table 6.2 The nine main pieces of legislation that have merged to become the Equality Act 2010
3. Table 6.3 Protected characteristics
4. Table 6.4 Examples of labelling, stereotyping and prejudice.
Chapter 07
1. Table 7.1 Working in a person‐centred way
2. Table 7.2 The principles associated with person‐centred values
3. Table 7.3 Health Foundation’s four principles that underpin person‐centredness
Chapter 08
1. Table 8.1 Factors that can have a detrimental impact on effective communication
2. Table 8.2 Indicators to support best practice for communicating
Chapter 09
1. Table 9.1 Respect and dignity
2. Table 9.2 Some of the ways the health and care worker can promote a person’s dignity
Chapter 10
1. Table 10.1 Components of a balanced diet
2. Table 10.2 Some signs, symptoms and consequences of malnutrition
3. Table 10.3 Some equipment available to support people in eating and drinking independently
Chapter 11
1. Table 11.1 Mental health statistics
2. Table 11.2 Some physical symptoms that people with depression may experience
3. Table 11.3 Some treatment options for depression
4. Table 11.4 Psychological, physical and behavioural symptoms associated with anxiety
5. Table 11.5 Some symptoms associated with dementia
6. Table 11.6 Two most common causes of dementia
7. Table 11.7 Degrees of learning disability
8. Table 11.8 Some barriers that can prevent people with a disability from living independently
9. Table 11.9 Legal frameworks and policy and guidance
10. Table 11.10 Principles to be followed when assessing capacity
Chapter 12
1. Table 12.1 Types of abuse
2. Table 12.2 Principles of safeguarding adults
3. Table 12.3 Issues that should be considered when a person discloses
4. Table 12.4 Immediate action to be taken if you see abuse or if abuse is disclosed to you
Chapter 13
1. Table 13.1 An overview of some elements of relevant legislation that may impact on the welfare of children
Chapter 14
1. Table 14.1 The DRSABCD acronym
2. Table 14.2 The AVPU scale for checking a response
3. Table 14.3 The ABCDE approach
Chapter 15
1. Table 15.1 Elements of legislation associated with health and safety at work
2. Table 15.2 What to do in emergency situations
Chapter 16
1. Table 16.1 The eight data protection principles
2. Table 16.2 The principles of good record keeping
Chapter 17
1. Table 17.1 Pathogens and some diseases that they may cause
2. Table 17.2 Modes of transmission
3. Table 17.3 Standard precautions

List of Illustrations

Chapter 01
1. Figure 1.1 Some key dates and events since the inception of the NHS.
Chapter 03
1. Figure 3.1 Three intertwined aspects of responsibility.
Chapter 04
1. Figure 4.1 A SMART goal system.
Chapter 05
1. Figure 5.1 Duty of care.
Chapter 07
1. Figure 7.1 The interrelationship of values and the person.
2. Figure 7.2 Factors associated with wellbeing.
Chapter 08
1. Figure 8.1 The components of effective communication.
Chapter 09
1. Figure 9.1 The closely intertwined interrelated connections between respect, privacy and dignity.
2. Figure 9.2 Risk assessment: a cyclical approach.
3. Figure 9.3 Dependence/independence continuum.
Chapter 10
1. Figure 10.1 Food hygiene.
2. Figure 10.2 Food hygiene, hand washing.
3. Figure 10.3 The Eatwell plate.
4. Figure 10.4 Urine colour chart.
Chapter 11
1. Figure 11.1 Mental health conditions and interrelationships.
2. Figure 11.2 Severity of depression on a continuum.
3. Figure 11.3 The cycle of stigma.
Chapter 14
1. Figure 14.1 The heart and blood flow.
2. Figure 14.2 An overview of the respiratory system.
3. Figure 14.3 Adult basic life support flow chart. (Automatic external defibrillator (AED)).
4. Figure 14.4 Jaw thrust.
5. Figure 14.5 Chest compressions.
Chapter 15
1. Figure 15.1 Workplace hazards.
2. Figure 15.2 The five steps associated with a risk assessment.
3. Figure 15.3 Components required to support a fire.
4. Figure 15.4 Some aspects of the physical and psychological impact of stress.
Chapter 17
1. Figure 17.1 The chain of infection.
2. Figure 17.2 Hand‐washing technique.
3. Figure 17.3 The five moments of hand washing.

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Cover image: © Dean Mitchell/Getty Images.

Chapter opener images reproduced courtesy of Anthony Peate.

Preface

The provision of health and social care along with support provided to people is changing and will continue to change. In the healthcare sector in England there is to be a new nursing associate role, to provide greater support for nurses and help to bridge the gap between healthcare support workers and nurses. The nursing associate will be trained through the apprenticeship route. Once trained they will work alongside healthcare support workers to deliver hands‐on care, freeing up time for existing nurses so they can use their specialist training to focus on clinical duties and take more of a lead in decisions around patient care.

This text has been written for staff who are new in their role as well as for those who are already employed as a healthcare assistant, assistant practitioner, care support worker or those who provide support where there is direct contact with people receiving services. The book will also be suitable for those who are contemplating undertaking the role of nursing associate. Adult social care workers who provide direct care in residential and nursing homes or a hospice, or home care workers will also find the content of this book applicable to their sphere of work. It is acknowledged that roles undertaken will vary in different health and social care settings.

In England in April 2015, the Care Certificate was introduced. The Government now expects that all those working as healthcare assistants and adult social care workers will undertake learning related to the standards of the Care Certificate as part of their induction programme. The Cavendish Review, published in July 2013, was one of the key drivers for the creation of the Care Certificate.

An Independent Review into Healthcare Assistants and Support Workers in the NHS and social care settings was undertaken in 2013 (Cavendish, 2013). It was estimated that there are over 1.3 million frontline staff who are not registered with a regulatory authority but who now deliver most of hands‐on care in hospitals, care homes and the homes of individuals (Cavendish, 2013). The Cavendish Review (requested by the Secretary of State for Health in the wake of the publication of the Francis Inquiry into Mid‐Staffordshire NHS Foundation Trust) examined what could be done to ensure that unregistered staff in the NHS and social care treat all people with care and compassion.

The review revealed how disconnected the systems are that care for the public, and amongst other things proposed new common training standards across health and social care, grounded in what the best employers already do. It proposed a Certificate of Fundamental Care, written in plain English, to make a positive statement about caring necessitating the Care Quality Commission (CQC) to require all workers to have achieved this Certificate prior to working unsupervised.

There are often inconsistent approaches to the training and development of healthcare assistants and adult social care workers, with varying quality. The Care Certificate has been created to address these variances. The Care Certificate consists of 15 standards; these standards address the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England but can also be applied to the three other UK countries.

The Care Certificate applies across the health and social care sectors and is portable between sectors and organisations. The Care Certificate covers the learning outcomes, competencies and standards of behaviour that are expected of support workers in the health and social care sectors. The Care Certificate defines the required values, behaviours and competencies that carers must demonstrate, aiming to ensure that the care and support offered is caring, compassionate and of a high quality.

Each of the standards related to the Care Certificate has specific outcomes and competencies that are associated with them; these must be achieved in order for one to be eligible for a Care Certificate; assessment of both knowledge and competence is required. It is not the purpose of this book to replace the Care Certificate standards; however, working through the various chapters will enable the reader to develop their knowledge and apply this to their work.

The Care Certificate cannot be completed through completion of e‐learning or completing a workbook alone. E‐learning or workbooks can support the attainment of knowledge but the assessment of the required skills has to be undertaken in the workplace.

The chapters

There are 18 chapters in the book. The first chapter provides an overview of health and social care provision, and Chapter 2 outlines the importance of working with others as a member of a team. Fifteen chapters are dedicated to the Care Certificate, and the final chapter, Chapter 18, provides support to the health and social care worker in addressing questions, queries and concerns that they may have or have experienced in the workplace.

The text adopts an engaging practical approach, and where appropriate practice exercises have been incorporated encouraging the reader to stop, look, listen and act, to take stock and carry out activities pertinent to the chapter. Where appropriate the student will be encouraged to interact with chapter content by completing activities, engendering curiosity. Reflection comes in the form of thinking activities.

Where appropriate at the beginning of the chapter the outcomes associated with each standard will be reproduced, contextualising and focusing the reader on the chapter content and relevance to the Care Certificate. There is an opportunity for readers to self‐assess. Readers can rate their current knowledge and skills prior to reading each chapter in relation to the chapter content. Each chapter ends with a case study reflecting chapter content. A resource file is included, inside which are resources that will help the reader to seek support and access further information should this be needed. These include links to the World Wide Web or references to appropriate literature.

An annotated bibliography has been provided. The purpose is to provide the reader with further information to support their learning.

What’s in a name?

The terms used to describe the relationship between those who provide care and offer support and those who are the recipients of those services vary; for example, user, service user, consumer, patient, client, survivor and expert are used. This text uses the terms ‘people’ or ‘person’ to describe those who receive or access services.

Terminology, job titles and roles in healthcare also vary; these can include: Assistant Practitioner, Care Assistant, Healthcare Support Worker, Maternity Support Worker, Nursing Assistant, Occupational Therapy Assistant, Physiotherapy Assistant, Radiography Assistant, Speech and Language Therapy Assistant and Senior Care Assistant. In Adult Social Care these roles and titles may include: Activities Worker, Day Care Assistant, Day Care Officer, Domiciliary Care Worker, Home Care Worker, Nursing Home or Hospice Nursing Assistant, Personal Assistant, Reablement Assistant, Residential Care Worker, Senior Home Care Worker and Support Worker.

I have enjoyed writing this text and I sincerely hope that you enjoy reading it and that you are able to apply the content to the care and support that you offer people.

Ian Peate
Gibraltar

Reference

Cavendish, C. (2013) The Cavendish Review. An Independent Review into Healthcare Assistants and Support Workers in the NHS and Social Care Settings. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/236212/Cavendish_Review.pdf (accessed August 2016).

Fundamentals of Care

A Textbook for Health and Social Care Assistants

Preface

The chapters

What’s in a name?

Reference

Acknowledgements

How to use your textbook

Features contained within your textbook