Care Planning Processes

09/10/2019
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Unit 20: Care Planning Processes
in Healthcare Practice
Session 3
L01
Objectives
Discuss applicable principles of legislative and
regulatory frameworks supporting equality and
diversity in the assessment process.

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What is assessment
Assessment is not about listing problems; it is as much
about finding out what the patient can do as it is about
finding out what they cannot do. Consequently, it
becomes a multi-stage procedure that produces a
detailed representation of the patient. It should offer a
true likeness of them as an individual, highlighting their
needs (present and near future) and the resources that
they have available to them to deal with these needs.
A comprehensive assessment that offers an objective,
accurate, detailed account of the individual and their
life must be conducted and then documented for all to
see. (Barrett, Wilson and Woollands, 2018)
Statutory requirements and
guidelines
The General Data Protection Regulation (GDPR) 2018 regulates the
use of this information (‘data’) to balance the individual’s right to
confidentiality and an organisation’s need to use it.
The mutually agreed General Data Protection Regulation (GDPR)
came into force on May 25, 2018, and was designed to modernise
laws that protect the personal information of individuals.
The General Data Protection Regulation (GDPR) 2018 replaces the
Data Protection Act 1998. This covers any information related to a
natural person or ‘data subject’ that can be used to directly or
indirectly identify the person. It can be anything from a name, a
photo, an email address, bank details, posts on social networking
websites, medical information, or a computer IP address. It also
introduces ‘digital rights’ for individual citizens. (Burgess, 2018)
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The GDPR sets out seven key
pri
nciples:
Lawfulness, fairness and transparency
Purpose limitation
Data minimisation
Accuracy
Storage limitation
Integrity and confidentiality (security)
Accountability
Week 2 Unit 17 5
7 Privacy principles of
GDPR(2018)
1. Lawfulness, fairness and transparency
2. Purpose limitations Personal data can only be obtained for specified,
explicit and legitimate purposes and can only be used for a specific
purpose and no other, without further consent.
3. Data minimisation No more than the minimum amount of data
should be kept for specific processing.
4. Accuracy Data must be accurate and where necessary kept up to
date.
5. Storage limitations Data no longer required should be removed.
6. Integrity and confidentiality Data must be handled in a secure
manner
7. Accountability all personnel dealing with personal data are
accountable and responsible for following the principles safely.
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(Ico.org.
uk,
2019)
Week 2 Unit 17 7
Key Difference between GDPR(2018)
and
Data Protection Act (1998)
There is no principle for individuals’ rights. This is
now dealt with separately in Chapter III of the
GDPR.
There is no principle for international transfers of
personal data. This is now dealt with separately in
Chapter V of the GDPR; and there is a new
accountability principle. This specifically requires
you to take responsibility for complying with the
principles, and to have appropriate processes and
records in place to demonstrate that you comply
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Confidentiality, Integrity, Availability
Confidentiality is about
privacy and ensuring
information is only
accessible to those with a
proven need to see it.
Integrity is about
information stored in a
database being consistent
and un-modified.
Availability is about
information being there
when it’s needed to
support care.
9
Freedom of Information Act (2000)
This Act grants people right of access to information
not covered by the Data Protection Act 1998.
There is a right under the Freedom of Information Act
and the Environmental Information Regulations (EIR) to
request information held by public authorities. This
came into force in January 2005 and is known as ‘the
right to know’. It allows you to access recorded
information (such as emails, meeting minutes, research
or reports) held by public authorities in England,
Northern Ireland and Wales
For example information which does not contain a
person’s identifiable details.
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Application to assessment
Think about the following questions when applying GDPR (2018)
and Freedom of Information Act (2018)
Is the care individualised and patient-centred?
Is the care safe, legal and ethical?
Is the care based on evidence or research?
Are the resources necessary to deliver care – knowledge, skills,
staff and equipment – available?
Was consent obtained in order to carry out the plan of care?
Was dignity and respect for the patient maintained at all times? did
you follow the instructions accurately?
Did you communicate with the patient, their carers and your
colleagues in an effective and considerate way about the care?
Were the actions documented in accordance with the relevant
organisational and professional guidelines and policies?
In groups can you discuss how you would use the legislation and
statutory requirement in assessment . Share Ideas
Legislation
The Human Rights Act 1998
Sets out the basic rights of every
human being in the UK
Legislation
relating to equality,
diversity and
discrimination
The Care Act 2014
■ Introduces the
wellbeing principle
■ Makes care and
support clearer and
fairer
The Health and
Social Care Act 2012
Aims to give
individuals a greater
voice in their care
The Equality Act 2010
■ Makes it unlawful to
treat people unlawfully
because of protected
characteristics.
■ Protects those
associated with
individuals with
protected
characteristics
The Mental Capacity Act 2005
Protects people who do not have
the capacity to make their own
decisions

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The code of conduct
The code of conduct for Healthcare Support
Workers and Adult Social Care Workers
includes the following principles:
Be accountable
Promote and uphold privacy,
dignity, rights, health and wellbeing
Work in collaboration
Communicate in an open, and effective way
Respect a person’s right to confidentiality
Strive to improve the quality of care
and support
Uphold and promote equality, diversity
and inclusion.
Challenging discrimination
Discrimination and discriminatory behaviour does not
uphold an individual’s rights and must be challenged.
It can take courage to recognise and change
discriminatory practice
Courage
Be courageous to challenge or confront situations that you know are not right and
that do not promote the wellbeing of all individuals.

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Discrimination
Discrimination
Activities organised in a place
without wheelchair access
Meals are only served between
8am and 5pm
Complaint forms are only
produced in English
Smaller portions of food are given
to women than men
Diversity
Meals are supplied that meet
individuals’ preferences
Individuals are given the support
they need to take part in
activities.
Direct or deliberate
discrimination is done on
purpose and is easy to recognise
Unintentional or inadvertent
discrimination may not be as
easy to recognise.
Reducing the likelihood of discrimination
Ways of working that promote
equality, diversity and inclusion
reduce the likelihood of
discrimination. You should:
Provide care that is person centred
care
Treat the individuals you
support as unique
Work in non-judgemental ways
Follow the agreed ways
of working
Work in an inclusive way
Challenge discriminatory practice.
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Definitions
Working in ways that promote Equality, Diversity
and Inclusion ensures that care is fair and
individuals are not discriminated against
Equality
Means giving everyone
equality of opportunity
in line with their needs
Diversity
Can be described as
the differences that
make people unique
Inclusion
Means involving
people within a group
or within society
Discrimination
Means to exclude people because of their differences. It involves treating
people differently because of assumptions made about a person or group of
people based on their differences.
Equality Act 2010
The Equality Act 2010 replaced nine major pieces of
legislation and should make it easier for health and social
care organisation to understand their legal responsibilities
and tackle inequalities in health care.
In particular, a health and social care organisation must not
discriminate, harass or victimise an individual or potential
patient in relation to:
Admissions.
The way it provides services to individual.
How it provides access to any benefit, facility or service.
Excluding an individual or subjecting them to any other
detriment.

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The Equality Act 2010 applies to everyone
who provides a service to the public, whether
or not a charge is made for that service. It
covers statutory, private, voluntary and
community sector organisations.
Everyone has the right to be treated with
dignity and respect. The Equality Act 2010
prohibits discrimination on named grounds.
These are called ‘protected characteristics’
Protected characteristics
The Act uses the term “protected characteristics” to refer to
aspects of a person’s identity. Treating a person less favourably
because they have one or more of these characteristics would be
unlawful. The protected characteristics are:
Age.
Disability.
Gender reassignment.
Marriage and civil partnership.
Pregnancy and maternity.
Race.
Religion or belief.
Sex.
Sexual orientation
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What actions and behaviours are
unlawful?
The Act defines a number of types of unlawful
behaviour, including:
Direct discrimination.
Indirect discrimination.
Failing to make reasonable adjustments for disabled
pupils or staff.
Discrimination arising from disability.
Harassment related to a protected characteristic.
Victimisation of someone because they have made,
or helped with, a complaint about discrimination.
The Equality Act 2010 prohibits not only direct
discrimination but also indirect discrimination,
harassment or victimisation.
The Equality Act 2010 requires public bodies and
those carrying out public functions to have due
regard to the need to eliminate unlawful
discrimination, advance equality of opportunity
and foster good relations between people from
different equality groups. This is called the public
sector equality duty.

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Application to Assessment
Personalisation
The Equality Act 2010
provides a legal framework
which can support
personalisation in adult
social care.
Personalisation is ensuring
individuals receive services
that are respectful,
effective and accessible.
This means starting with the
person as an individual with
strengths, characteristics,
preferences and aspirations
and putting them at the centre
of the process of identifying
their needs and making
choices about how and when
they are supported to live
their lives. (Social Care
Institute for Excellence , 2019)
Personalisation is about giving people much
more choice and control over their lives in all
social care settings and is far wider than
simply giving personal budgets to people
eligible for council funding. Personalisation
means addressing the needs and aspirations
of whole communities to ensure everyone has
access to the right information, advice and
advocacy to make good decisions about the
support they need.

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Application of Dignity and Privacy
Promoting equality and diversity and the cultural
implications for care and effective communication
Dignity in Care
Showing respect and respecting basic Human RightsPrivacy and independence *HRA 1998
Giving clients privacy
Communicating effectively-asking person receiving care
what their specific wants and desires are.
Being patient
Taking into account peoples cultural and religious needs
Promoting safe environment (Smith, 2010)
The Care Act 2014 replaces many
previous laws
26

1948 1960… 1970… 1980… 1990… 2000… 2010…

National
Assistance Act
1948
NHS and
Community
Care Act 1990
Carers
(Recognition and
Services) Act
1995
Chronically Sick
and Disabled
Person Act 1970
Community Care
(Direct
Payments) Act
1996

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What is the Act trying to achieve?
That care and support:
is clearer and fairer
promotes people’s wellbeing
enables people to prevent and delay the need for care and
support, and carers to maintain their caring role
puts people in control of their lives so they can pursue
opportunities to realise their potential
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An integrated Act
Different sections of the Act are designed to work together
Local authority wide
Overlap with Children and Families, including transitions
Partnerships and integration
Leadership
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The framework of the Act and its
statutory guidance
29

Assessment and
eligibility
Charging and
financial
assessment
Care and support
planning
Personal
budgets and
direct payments
Review
on
n,
ps
ns
n,
nd
cy
of
nd
ht
ng
Preventi
Integratio
partnershi
and transitio
Informatio
advice a
advoca
Diversity
provision a
market oversig
Safeguardi
Wellbeing
Key processes
General
responsibilities and
key duties
Underpinning
principle

Changes to assessment, eligibility and
financial assessment processes
30
Deferred
payment
agreement
Person appears
to have needs
Assessment
Are their
needs
eligible?
YES NO
(written
explanation)
Financial
assessment
Advice and
information

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Changes to care and support
planning processes
31
What might this mean for people
needing care and support?

Better access to information and advice, preventative services, and
assessment of need

An entitlement to care and support
A cap on care expenditure which an individual is liable for comes into
effect from April 2016
A common system across the country:
Continuity of care
Fair Access to Care Services (FACS) replaced by a national
eligibility threshold
32
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Costs are capped
There is a cap on expenditure
on eligible care from April
2016
Every year the local authority
• Reviews your care needs and financial
situation
• Keeps a record, from April 2016, called a
care
account
, of how much eligible care you have
needed in total
How much you might pay for your
care and support depends on your
financial situation
You have a financial
assessmen
t to see
what you have to pay
If you have care and support needs, you could be supported by…
Assessment of the care
and support you need, and
eligibility for state support
Information and advice
on local services and
how much they cost
Reablement,
rehabilitation
and
other free services
How will people experience the new
system in 2016/17?
Support from
family, networks
community…
What does this mean for carers and care
planning?
The Care Act strengthens the rights and recognition of carers:
Improved access to information and advocacy should make it easier
for carers to access support and plan for their future needs
The emphasis on prevention will mean that carers should receive
support early on and before reaching crisis point
Adults and carers have the same rights to an assessment on the
appearance of needs
A local authority must meet eligible needs of carers and prepare a
support plan
A carer should be kept informed of the care and support plan of the
person they care for
Children and Families Act 2014
34
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What might this mean for local authorities?
New duties and responsibilities
Changes to local systems and processes
More assessments and support plans
Responsibilities towards all local people
Better understanding of self funders and the care market needed
Training and development of the workforce
Costs of reforms
Preparation for reforms needed
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Reference

Barrett, D., Wilson, B. and Woollands, A. (2018). Care Planning: A
guide for nurses
. 3rd ed. New York: Routhledge.

Social Care Institute for Excellence (SCIE). (2019). Personalisation
briefing: implications of the Equality Act 2010
. [online] Available at:
https://www.scie.org.uk/personalisation/introduction/equality-act-2010
[Accessed 9 Oct. 2019].
Smith, B. (2010). Student nurse survival guide. Harlow: Pearson
Education.