Case studies: Merryvale Residence, Zebra ward
P1 - Implications of the duty of care
A duty of care is owed to service users, colleagues, your employer, yourself, visitors, family, and
friends of service users and the ‘public interest,’ this is anyone likely to observe or be affected
by your actions
Legal obligation to protect wellbeing and prevent harm. A duty of care is a moral and legal
obligation to maintain the safety and wellbeing of others. You should always act in the best
interest of service users that may be affected by your actions. You should know your limits and
act within your level of competence (you shouldn’t complete tasks that you cannot perform
safely). Working in health and social care means you must consider the public's confidence in
your ability to safeguard the welfare and the best interests of service users. You have a
responsibility to behave in a way that promotes welfare that doesn’t cause harm and applies to
all health and social care workers.
A part of the professional conduct is setting relationship boundaries. It is important to
understand that a professional relationship should have boundaries. You should provide care
without becoming emotionally attached (this is called professional detachment).
Upholding the rights and promoting the interests of individuals experiencing abuse or
neglect. some service users may feel that they are not able to ask for what the need because
they are physically intimidated or scared by a member of staff or their own family, a friend, or
another service user. A service user might have a specific trust in you and may find yourself
acting as an advocate for that person to ensure that the are treated equally and their diversity
is respected.
All service users have unique needs and abilities, some service users may have the ability to
protect their rights because they do not have the mental capacity to understand the
implications of their circumstances. Disrespectful remarks or impacts may have an impact on a
service users' self-esteem. It isn't your role to judge a service user and you should always tell
the truth.
Protecting health, safety, and wellbeing. To all service users, you are in a place of trust. It's
important to understand that a service user may be vulnerable, and that you must take
responsibility for the unequal distribution of power, so that the service user isn't exploited,
intimidated, or unjustly treated.
You should always explain to your manager how your actions were safe and fair, when working
with service users. You have a duty, as an employee, to take care of yourself ad to considers
how your actions impact other people.
Ensuring safe practice. Workplace policies set by your employing organization organisation
must be followed or put into place.
,The CQC required that health and safety training should be a part of your introduction to the
care workplace. Training is an important part of safe and effective working practice, and you
should ensure that you attend you training sessions to learn about important aspects of the job
role.
Balancing individual rights with risks. People’s choices usually have an effect on other
individuals. Health care professionals may have power over those in their care that service
users find difficult to challenge. Many service users fear losing their independence, which can
cause conflict with health care professionals, friends, and family, who feel that the service user
may not cope with independent living. Service users have the right to accept or to reject any
course of treatment or care that is offered to them.
You should always think of the service user as an individual. Service users have the right to
make informed choices even if those choices may involve a small amount of risk.
In the Merryvale residence, the duty of care isn’t being enforced to the standards that it should
be.
Two of the females are experiencing discrimination as they are in a same sex relationship and
have not been provided a double room. They have not been made aware of what their legal
rights are and do not want to complain as they do not want to cause problems. Balancing
individual rights with risks, their right to their decisions is not being enforced, even if the care
workers think it’s a bad idea, they still have the legal right to choose, and diversity and inclusion
isn’t being respected. They’re being discriminated against, which is going against the equality
act, and they may start to feel that they are being judged and their self-confidence may be
affected.
One of the women has realised her partner, who has help with dressing and bathing, has
bruises on her neck and arms, and when her partner asked her about it, she stated that she fell
over. The rights and promoting the interests of individuals experiencing abuse or neglect are
not being respected. The lady makes excuses for her bruises, suggests that she is being
physically intimidated by a care worker. A service user should trust you. Her bruises may be due
, to someone lifting her incorrectly etc. this infringes the legal obligation to protect wellbeing and
prevent harm. Risk assessments should be done before using equipment’s etc. and it should
only be performed if you have the competence to (if you are fully trained on it). On the other
hand, her bruises may be due to an abusive relationship, correct procedures should be put into
place when reporting this and shouldn’t be ignored. The implications of this can be severe, if
abuse isn’t acknowledged it can get worse and could result in severe or fatal injuries and can
make the service user feel inferior and scared.
The care home will often operate with less than the legal limit of care workers, meaning that
service users who need support with personal care have to wait for long periods of time or have
to manage by themselves. And some remained without a shower or a bath for two or three
days, which can worsen the skin conditions of some residents. They are experiencing neglect,
which infringes the duty of care, and their rights aren’t being upheld. A high quality of care is
not being provided and service users are not being treated with dignity and respect. Service
users may feel that they are not being valued or they may feel depressed due to not feeling
clean.
P2 how complains and appeals address failure in a duty of care
Complaint's procedures can be submitted by anyone who is using or working in care setting that
wishes to complain. Complaints are made if:
Service users are not having their needs met, in the zebra ward bruises at the base of
Kevin’s spine and the round marks on Lucy’s neck are overlooked by, a doctor and a
nurse, a complaint about this could be made by the visitor or the social worker. Kevin
and lucy are not having their needs met and if this continues to be overlooked this may
result in more harm being done to them.
A care workers behaviour or attitude isn’t up to standards, they may be abrupt,
disrespectful, or careless. The nurse in the zebra ward is careless, as he forgets to report
the marks before he goes off duty.
Discrimination is taking place, service users may feel that they are being treated less
favourably and comments may be passed off as a joke (they may be discriminated over
gender, race, disability, or sexuality etc.)
The cost of care, a service user may feel that they are not being given the value for their
money.
Abuse or neglect is taking place, if there are any signs of abuse it should always be
reported. In the zebra ward when the father comes back to visit the children, they
display that they are scared of the father and hide from him or cry when he picks them
up, the nurses brush this off as shock from the crash and is not noted. This is a very low
quality of care and should have been reported.
In the zebra ward a visitor and a social worker are not convinced and ask to speak to a ward
manager. They want to make a complaint to the manager, and he says that he cannot discuss