An Investigation of Principles, Care Strategies and Theories Related to Social Care Practice
This section provides a summative assessment of the principles, care strategies and theories that direct social care work within the UK. Specifically, the application of support principles, procedures for protecting clients from harm and the advantages of utilising a person-centred approach in working with clients are discussed. Additionally, ethical issues, applicable policies, legislation issues and regulation and the impacts of existing policies are presented in relation to providing social care.
Applications of Support Principles
Ensuring that individuals are properly cared for in health and social care requires the application of a number of support principles. Examples of these support principles include equity in the provision of care, universality in its accessibility and providing multiple financial options for individuals of all backgrounds (Alcock, Daly & Griggs, 2008). As the individuals who require health and social care services differ in their ethnic, cultural, social and socioeconomic backgrounds, these support principles are pivotal in meeting the needs of the greatest percentage of the population (Alcock et al., 2008). Valuing diversity and providing support for families of varying backgrounds is a critical component of UK health and social care policy (Alcock et al., 2008).
Procedures for Protecting Clients from Harm
Protecting clients from harm is another important consideration for social care home managers within the UK. Generally, clients taking advantage of social care services are in vulnerable positions, and face financial, psychological or medical difficulties that make them prone to potential harm or abuse (Alcock, May & Rowlingson, 2008). The practise of safeguarding social care receivers is critical to preventing such abuse (Alcock et al., 2008). Current National Health Service (NHS, 2012) policy mandates that health and social care workers adhere to strict procedures for preventing neglect or abuse. Practitioners are held accountable for the services they provide, as well as their efforts to empower clients, protect their confidentiality and basic human rights and taking any additional measures necessary to protect vulnerable clients (NHS, 2012).
Benefits of the Person-Centred Approach
The person-centred approach guides all current UK health and social care practice (Edwards, 2012). This model of care, based on the early therapeutic work of Carl Rogers, emphasises protecting the individual rights of clients, and making decisions in a manner that best meets their unique needs (Moon, 2008). While this term is used frequently in other health and social care systems, many find themselves actually relying on financial and political considerations when planning care (Moon, 2008). The NHS prides itself on placing client satisfaction in the spotlight and enacting legislation that protects this person-centred approach, such as the Human Rights and Equality Acts (NHS, 2012). The advantages of this model range from increased client satisfaction, the ability to reach individuals from a diverse range of ethnic and financial backgrounds and more effective case outcomes (Edwards, 2012).
Ethical Dilemmas and Conflicts
Health and social care is a field rife with potential ethical dilemmas and conflicts. Examples of ethical dilemmas that commonly arise in this field are potential legal violations on the part of a client or colleague, the necessity to select between case alternatives that do not meet client needs, reporting unethical or illegal behaviour on the part of the client and negotiating roles and responsibilities when working with vulnerable population members (Edwards, 2012). Due to the sometimes-sensitive nature of the health and social care field, the NHS maintains ethical guidelines and policies for all practitioners to follow (McLean, 2010). Additionally, these guidelines are subject to perpetual reform to adapt to changing population needs (McLean, 2010).
Implementation of Policies, Legislation, Regulations and Codes
The NHS continually evaluates its policies, legislation, regulations and codes to ensure they are relevant and specific to the varying ethnic, cultural and financial backgrounds of the population (Tingle & Bark, 2011). The Health and Social Care Act 2012 currently serves as the most extensive legislation guiding the field within the UK (Department of Health, 2012). This act maintains policies on health and social care providers, professional accountability and the organisation of the field (Department of Health, 2012). Within this act are specific policy standards providing a greater voice for patients, a more patient-centred model of care and standards on streamlining health and social care services to prevent inefficiency (Department of Health, 2012). The result of this act has been greater accessibility of care and improved health and social care efficiency (Department of Health, 2012).
Local Policies and Procedures
While UK legislation guides health and social care practice throughout the region, local policies and procedures may vary depending on population needs (Tingle & Bark, 2011). For example, regions with higher or lower socioeconomic statuses may adapt local health and social care policy accordingly (Tingle & Bark, 2011). In such cases, local government associations or community well-being associations can convene to reform procedures in a manner that best meets local needs (Department of Health, 2012). These organisations serve to inform NHS policy through highlighting various local health and social care needs (McLean, 2010). Through adapting local policies and procedures to meet community need, the NHS is able to deliver a higher quality of service on a national level (McLean, 2010).
Impact of Policy, Legislation and Codes of Practice
Legislation, policy and code reform have a profound impact on health and social care practice. This reform protects both clients and practitioners, and provides practical guidance as to best practices related to specific social care needs (Department of Health, 2012). The aim of evaluating policy, legislation and codes of practice is to ensure that standards are current, relevant, clear to clients and practitioners and ensure the safe and ethical care of all individuals (Tingle & Bark, 2011).
Changes in rules and legislations regarding health and social care practice serve to protect clients from discrimination and facilitate optimal person-centred care. Understanding the theories, social processes and professional roles involved can promote more holistic care delivery and prevent common ethical dilemmas. This section discusses such theoretical contributions to the health and social care field, as well as changes in organisational policy.
Theories Underpinning Health and Social Care Practice
Theory is critical to the field of health and social care, as it directs all practice (Jones & Atwal, 2009). The general theories and models of care utilised within the healthcare system ultimately dictate its legislation and policy reform (Jones & Atwal, 2009). Furthermore, delivering care based on theory helps guide future health and social care research (Jones & Atwal, 2009). Health and social care within the UK is largely based on humanistic theory (Edwards, 2012). Humanistic theory emphasises the individual needs of each individual in designing care services, protecting clients' individual rights, autonomy and dignity (Levin et al., 2011). Additionally, humanistic health and social care values the significance of effective communication with clients and colleagues, as well as in inter-professional working environments (Edwards, 2012). Humanistic theory is responsible for the person-centred model of care practised within the UK, which has subsequently directed recent policy reform (Levin et al., 2011). Additionally, social learning theory has had a large impact on health and social care practice in the UK (Jones & Atwal, 2009). This theory highlights the importance of learning through observation and modelling in terms of adhering to a care plan (Jones & Atwal, 2009). Through understanding the significance of this form of learning, care home managers can empower clients and provide the best possible care to individuals of diverse backgrounds (Mendelstem, 2009). Theory-driven health and social care practice is generally better suited to address the multiple factors that influence practice (Mendelstem, 2009). Finally, anti-oppressive theory and anti-discriminatory practice have shaped health and social care in the UK (Alcock et al., 2008). Anti-oppressive theory pertains to a style of professionalism that emphasises the role of social justice and the significance of individual rights (Alcock et al., 2008). Anti-discriminatory practice refers to social work that serves a range of diverse social and ethnic backgrounds, and does not limit service based on any of these characteristics (Alcock et al., 2008).
Impacts of Social Processes
Social learning and other social processes can impact health and social care services in varying ways. For example, user involvement has recently been a key focus of policy reform within the UK (King's Fund, 2011). This practice has promoted a more patient-centred health care model that accounts for the perspectives of both patients and caregivers (King's Fund, 2011). Research (e.g., Levin et al., 2011) has demonstrated that user involvement has improved service related to cancer care, as well as other disciplines within the health and social care umbrella. Forming a partnership with health and social care users and professionals can improve the inter-professional working environment and strengthen individual impacts on both policy and care (King's Fund, 2011). Additionally, engaging users and accounting for social processes in directing health care policy has shifted the current model from a reactive-oriented approach to one that is more proactive (Hearnden , 2008). Through incorporating service users, for example, the health and social care field has been able to anticipate cultural change and meet the needs of an increasingly diverse population (Hearnden , 2008). Finally, the combination of the engagement of users and the person-centred care model, the process of social exclusion within the health care system has largely been avoided (Hearnden , 2008).
Effectiveness of Inter-Professional Working
Health and social care within the UK is trending toward an increasingly inter-professional working model (Wallace & Davies, 2009). This health and social care policy promotes the collaboration of professionals to best meet the needs of clients (Wallace & Davies, 2009). The NHS has incorporated this policy into its legislation, and emphasises care that fosters working relationships between differing professional organisations (Trodd & Chivers, 2011). This model of care has resulted in a higher level of care within the UK, and has been critical in transforming perspectives on healthcare (Trodd & Chivers, 2011). Accompanying the inter-professional model of care in the UK has been a more collaborative educational model (Courtenay, 2012). Practitioners are increasingly trained to incorporate an understanding of inter-professional care into their academic programmes, leading to a more holistic and patient-centred healthcare system (Courtenay, 2012). The sharing of knowledge that has resulted from this inter-professional model has subsequently created more effective and efficient care plans (Jones & Atwal, 2009). Though the implementation of an inter-professional working environment into practice has faces several challenges, such as a lack of support or training from managers, consistent evaluation and reform has led to improvements in the level of care throughout the UK (Trodd & Chivers, 2011). Perhaps the most important area in which inter-professional working has been effective is its ability to transcend professional boundaries (Courtenay, 2012). Through effective collaboration with colleagues, professionals are able to share responsibilities and bypass many of the conflicts that previously detracted from these collaborative efforts (Courtenay, 2012). The result has been a more efficient and effective model of care (Courtenay, 2012).
Role, Responsibilities, Accountabilities and Duties
Regardless of one's specific role within the health and social care system, working within a team environment enables professionals to work through difficult practical problems (Mendelstem, 2009). Additionally, the inter-professional working environment allows professionals to share resources, knowledge and services to solve these complex challenges (Mendelstem, 2009). All professionals are responsible for maintaining ethical codes and professional standards related to their specific health and social care discipline. The effective sharing of information within an inter-professional work environment requires that individuals are held accountable for maintaining a high level of expertise, and effectively carry out their professional duties (Mendelstem, 2009). Each individual within the inter-professional working environment is also responsible for demonstrating the values and principles set forth by the NHS and their specific professional governance (Jones & Atwal, 2009). Collaborating with colleagues requires ethical conduct, effective verbal and non-verbal communication, respect for the contributions of other members of the care team and sharing responsibilities and professional duties (Harlen, 2005). Understanding these roles, responsibilities, accountabilities and duties facilitates a more holistic, patient-centred model of care (Day & Wigens, 2006). As a health and social care student, educating one's self regarding these factors and their influence on policy is critical to future practice. Encouraging this understanding further improves the quality and efficiency of the healthcare system (Day & Wigens, 2006).
Contributions to Organisational Policy
Many roles within the health and social care field serve to assist in the implementation and reform of national healthcare policies (Jones & Atwal, 2009). As health and social care is practiced in a diverse range of settings, these workers play a vital role in directing organisational policy (Edwards, 2012). No other professionals possess the combination of organisational and practical insight as health and social care workers, and these professionals are essential in enabling other professionals, such as government officials and educators, in carrying out their duties (Jones & Atwal, 2009). Additionally, health and social care workers are the first line of defence in safeguarding vulnerable population groups, and are primarily responsible for directing organisational policy regarding protecting these individuals (Department of Health, 2011). In protecting clients' rights, social care workers are important in obtaining the resources needed to promote best practice standards (Pereira et al., 2008). Finally, through engaging in ethical practice, effectively managing case loads and continuing to increase professional knowledge, social care workers are influential in contributing to organisational quality (Edwards, 2012).
Recommendations for Good Practice
In meeting good practice requirements, education and professional development are vital (Courtenay, 2012). Through continuing to receiver further training, professionals can sharpen their skills and best meet the changing needs of a diverse population (Courtenay, 2012). Additionally, incorporating evidence into practice can facilitate a higher level of quality in health and social care (Rushton, 2005). This practice involves the review and dissemination of current research surrounding health and social care, and the subsequent implementation of this evidence into professional practice (Day & Wigens, 2006). The combination of these strategies can ensure the safeguarding of vulnerable population groups, a more collaborative working environment and the successful adherence to best practice standards (Courtenay, 2012).
- Alcock, C., Daly, G. and Griggs, E. (2008). Introducing Social Policy, 2nd edit, London: Pearson.
- Alcock, P., May, M. and Rowlingson, K. (eds.). (2008). The Student's Companion to Social Policy, 3rd ed. Oxford: Blackwell Publishing.
- Courtenay, M. (2012). Interprofessional education between nurse prescribing and medical students: a qualitative study. Journal of Interprofessional Care. [online] Available at: http://informahealthcare.com/eprint/CPYbh6yxn64UppIy35J7/full [Accessed 28 February 2013].
- Day, J. and Wigens, L. (2006) Inter-professional working: An essential guide for health and social care professionals. London: Nelson Thornes.
- Department of Health (2011). Safeguarding Adults: The role of health services. [online] Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAnd uidance/DH_124882. Accessed 28 February 2013.
- Department of Health (2012). Health and Social Care Act Explained. [online] Available at: http://www.dh.gov.uk/health/2012/06/act-explained/. Accessed 28 February 2013.
- Edwards, A. (2012). Putting patients first. British Medical Journal, 344, pp. 233-240.
- Harlen, W. (2005). Teachers' summative practices and assessment for learning tensions and synergies. Curriculum Journal, 16(2), pp. 207-223.
- Hearnden, M. (2008). Coping with differences in culture and communication in health care. Nursing Standard, 23(11), pp. 49-57.
- Jones, M. and Atwal, A (2009). Preparing for Professional Practice in Health & Social Care. Chichester: Wiley-Blackwell.
- King's Fund. (2011). The future of leadership and management in the NHS. [online] Available at: http://www.kingsfund.org.uk/publications/future-leadership-and-management-nhs. Accessed 28 February 2013.
- Levin, R. F., Overholt, E. F., Melnyk, B. M., Barnes, M. and Vetter, M. J. (2011). Fostering evidence-based practice to improve nurse and cost outcomes in a community health setting. Nursing Administration Quarterly, 35(1), pp. 21-33.
- Mendelstem, M. (2009). Safeguarding vulnerable adults and the law. London: Jessica Kingsley. Publishers.
- McLean, S. (2010). Autonomy, Consent and the Law. London: Routledge-Cavendish.
- Moon, J.A. (2008). Reflection in learning and professional development: theory and practice. London: Routledge Falmer.
- National Health Services. (2012). The NHS Constitution. London: Department of Health.
- Pereira, J., Nagarajah, L., Win, K., Joachim, P. and Wjesuriya, L. (2008). Formative feedback to students: the mismatch between faculty perceptions and student expectations. Medical Teacher, 30(4), pp. 395-399.
- Rushton, A. (2005). Formative assessment: a key to deep learning. Medical Teacher, 26(6), pp. 509-513.
- Tingle, J. and Bark, P. (2011). Patient Safety, Law Policy & Practice. Abingdon: Taylor & Francis.
- Trodd, L. and Chivers, L. (2011). Interprofessional Working in Practice Learning and working together for children and families. Maidenhead: Open University Press.
- Wallace, C and Davies, J. (2009). Sharing Assessment in Health & Social Care - A Professional Handbook for Interprofessional Working. London: Sage.