Within caring for them. Nusrat is a 19 year

Within
health and social care there is always a goal to prevent discrimination and
promote equality whether it is with the staff or the service users. This is
vital in making sure that everyone gets the best possible environment for work
and help.

Equality,
Diversity, and discrimination are all linked very closely but have completely
different meanings. Equality is defined as “The right of different groups of
people to have similar social position and receive the same treatment”
Cambridge.org 2018. This means that everyone should be given equal
opportunities regardless of their characteristics. The Equality act of 2010
ensures that service users and workers are treated fairly by companies and are
not discriminated against due to their protected characteristics. These
characteristics are: race, sex, sexual orientation, gender, disability,
pregnancy and maternity, religion or belief, marriage and civil partnership.

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Diversity
is “The fact of many different types of things or people being included in
something; A range of different things or people.” Cambridge.org 2018. An
example of this would be the city of London as it has a large variety of people
from different cultures and religions all gathered in one place, making it a
diverse area.

Discrimination
is “Treating a person or particular group of people differently, especially in
a worse way from the way in which you treat other people, because of their skin
colour, sex, sexuality, etc.” Cambridge 2018. However, Discrimination is not
always negative. Positive discrimination is when a person or group of people
receive better treatment due to having a protected characteristic. For example,
A company might hire a person undergoing Gender reassignment to reach the
“standard” of diversity expected in a workplace.

In a
health and social care setting it is important to promote anti discriminatory
practices. The 3 Case studies I have chosen for this task are; Nusrat Patel,
Patrick Green, and Alice Fernandez. All three of these people have one or more
protected Characteristic that need to be taken into account when caring for
them.

Nusrat
is a 19 year old female with a learning disability and epilepsy. Her Care team
were sure to give her the treatment she needs, focusing on what she can do,
with the possibility to make adjustments if the care she receives did not suit
her. This had been achieved through communication with both her and her mother,
meaning that even though Nusrat could not always get across what she wanted or
needed, she was involved in the planning of her own care which was likely to
give her more confidence in the care she was being given. Due to her learning
disability, Nusrat was also given an advocate to attend the meetings and help
get across what she wanted to say. Although she was originally involved in the
meetings, the addition of an advocate means that the centre has taken a step to
avoid discrimination against her. She would have more of a say in what type of
treatment she got than without one as she was able to communicate effectively
with the staff at the centre, causing her to have as much freedom in what type
of support she recieved as a service user without a learning difficulty.

Patrick
Green is 26 years old and is in a relationship with a male partner. He has been
tested positive for HIV. His martial arts trainer, despite Patrick’s worries
will still allow him to use the facilities and continue taking classes without
any limitations, showing that he will be treated as if he was any other member
of the facility. The same goes for at the sexual health centre, where he will
still be treated with the same courtesy and respect of any other individual. This
is important as it will not only maintain good relations with both his trainer
and Simon at the sexual health clinic, but he will also be able to feel secure
and safe, instead of people treating him like a hazard and pushing him away
which could lead to him feeling unwanted and ‘dirty’. An act of
anti-discriminatory practice would be Simon at the sexual health clinic helping
to refer Patrick and James to a consultation at the Terrance Higgins trust,
where as a consequence they have been offered either face to face counselling
or online. They have spoken to their GP where necessary changes have been put into
place including a change of their lifestyle, and prescribed antiretroviral
treatment. This has also led to arrangements to meet the local housing officer
who could help them with any concerns involving housing.  

Alice
Fernandes is 74 years old and has a habit of spending her pension on alcohol
rather than on healthy food. Due to her alcohol intake she is giving off a
strong scent of alcohol which interrupts members of her aerobics class which
she takes part in. Although the manager has allowed her to continue taking her
classes there, he has asked her to remain separate from the other members as
they have complained about her scent being distracting. This decision was made
with the aerobics class and it is implied, without her knowledge. Although the
manager has to take everyone’s views into account, this could be considered an
act of direct discrimination because even though this is not caused by the
manager having an issue with any protected characteristics, they have decided
to treat her differently in a negative way and have her stand separately from
the group. However they did ask Alice to see a doctor due to her medication
making her lethargic and volunteered to act as an advocate at her meeting with
her G.P due to Alice finding it difficult to personally express her concerns.
As a result of seeing her G.P, both Alice and her doctor agreed that she should
be put in sheltered accommodation to receive support. After asking for a
meeting with a local housing association with the help of an advocate, the G.P
arranged for a volunteer advocate to attend the meeting with her to help
support Alice and help her get across what she wants to say.

Though
all three case studies had some indication of advocacy (Nusrat and Alice had
explicit advocates whereas Patrick’s trainer helped him make an appointment at
the sexual health clinic). This is not the only initiative that exists to
prevent discrimination.

These
include: complaint services, the equality act 2010 (This prevents employers,
care staff etc., from discriminating against someone due to protected
characteristics), mental capacity act 2005 (This act means that as long as
people have the capacity to make decisions effectively, they can decide what
they want e.g. what type of care they want to receive, however if they do not
have the capacity then they can have an advocate help them to decide or make
the decision for them.) etc.

When
caring for others, people should possess what are known as the 6 C’s. These are
care, compassion, competence, communication, courage and commitment.

Throughout
each case study, each of the 6 C’s are shown to be used in how people treat
those involved.

Nusrat’s
team showed care by having her involved in the meetings about the care she
receives and giving her an advocate so that she would be able to make her voice
heard in them. Showing a non-judgemental approach to her mental illness and
acknowledging that despite her illness, she should be able to have a say in the
type of care that she receives. It is mentioned in her case study that even
though she needs assistance when going to the toilet in case of an epileptic
episode, the person who accompanies her gives Nusrat as much privacy as they
possibly can, the care team has also made sure that her care plan is flexible
in order to make room for any changes in her condition, meaning that they made
the care plan about her and what suits Nusrat’s needs instead of using a
standard plan, which clearly shows that they have compassion for her. Nusrats
team show competence when they acknowledge that some parts of her condition are
out of their depth and they refer Nusrat to an epilepsy specialist where she
can receive support from someone with a higher level of knowledge about her
condition. It is said in the care plan that both Nusrat and her mother are
involved in meeting about her care. The care centre is also shown to give
refferals to other organisations and actively look for people who could further
help her with the care she receives, showing communication, communication
skills, and courage as they are trying to find the best care available for her
and actively conversing with Nusrat and her mother about the care she is
receiving. This also ties in to commitment as they are focused on Nusrat and
what type of help and support she needs. The fact that her care plan is
flexible to change also shows flexibility within staff in the care centre, who
are willing to change the type of treatment and support she needs where
appropriate, also showing observation skills as they would not be able to do this
without keeping an eye on her condition and whether it deteriorates or
improves.

Within
Patrick’s case study there are clear examples of care such as when he is
talking to his martial arts instructor and is reassured that despite having
HIV, he will not be treated any differently than the people who don’t, and he
is told the same by the sexual health clinic about how he will be treated
there. He was also told that he would be put in contact with a housing officer
to help support both him and his partner with any housing issues, this act
shows both care and compassion as it is clear the person at the sexual health
clinic cares about what could happen to Patrick in regards to his wellbeing.
This is also an example of Simon showing empathy to Patrick. Competence and
endearing trust was shown when Patrick’s martial arts instructor referred
Patrick to the sexual health clinic as he knew that he was not able to help
Patrick and instead passed him on to someone who could. Endearing trust was
shown when Patrick disclosed his possible illness to his martial arts teacher
as he didn’t have to tell him but decided to anyway, showing a trust between
the two individuals. Both his martial arts teacher and Simon from the sexual
health clinic showed communication on both a personal and professional level as
they both passed on necessary information such as his health worries but also
spoke with him on a personal level and reassured him that he would not be
shunned because of his HIV status, showing that both of them have good people
skills. Both showed courage and commitment to Patrick. Courage was shown by
Simon when he organised a meeting with the housing officer as he did not have
to do this but committed to it anyway as he believed that it would benefit his
service user. This act also showed commitment as he had Patrick’s best interest
in mind when making the arrangement an attempt to reassure him and giving a
higher level of wellbeing.

Care
was shown with Alice Fernandez when the manager of the centre she attends
aerobics in suggested that she should go to meeting for AA as well as talking
to her doctor about her medication making her lethargic, showing that he has
concerns about hear health and wellbeing. However, the manager also shows a
distinct lack of care when he says that the smell of alcohol on her caused
“distress to the trainer and class members” which made Alice feel victimised
and judged. This also points out a lack of empathy and communication skills on
a personal level as there may have been another way of wording it in order to
make sure she was not offended. It was implied they did not have any empathy
for her as the manager said how her scent caused distress to people, showing
that he was thinking more about the class members than on her and why she would
often smell of alcohol. However since they did give Alice some options on
people and places that could help her, they did still have enough compassion
and courage to try and help her but the competence to know that they did not
have any way of helping her themselves. Communication was shown by both Alice’s
doctor and the manager on a professional level. It was shown by the manager
when acting as an advocate for her during her session with the G.P, also
showing endearing trust as it was stated that she had trouble showing her
personal expressions but she trusted the manager to help her get across her
emotions. her doctor showed good communication on both a personal and
professional level when discussing her medication and asking her opinion on
being in sheltered living before making the arrangements for that to take
effect as they listened to what Alice had to say about the situation (personal
communication) and making contact with the accommodation association
(professional level). The G.P showed clear commitment to helping Alice as they
were not only willing to change her medication but also offer alternatives to
it for Alice, showing that they wanted Alice to receive the appropriate care
but in a way that would suit her preferences. The fact that the G.P was the one
who brought up the housing association further proves the commitment to care
they give her.

I
previously talked briefly about how some people in the case studies showed good
communication skills on a personal level but they also had more people skills.
The main one being problem solving skills.

This
was shown with Nusrat when talking about a member of staff assisting her to the
toilet as they recognised she needed help. As a result the staff did help her
but also tried to give her as much privacy as they possibly could by being as
discreet as possible. This is also an example of dealing with a difficult
situation as they needed to balance the support given to her with her right to
privacy.

Patrick’s
G.P showed problem solving skills by offering to arrange a visit with the local
housing officer in an attempt to try and help them with any problems that may
arise from his landlord as a result of his HIV positive status. While his
trainer did not show any problem solving skills he was able to deal with a difficult
situation. This could be considered as a difficult situation by the fact that
one of his students told him about a possible health problem and he had to find
a place where Patrick could get support and advice. He also showed honesty by
not only discussing with Patrick about setting up an appointment with the GP
and in reassuring him that the way he was treated at the classes would not
change.

For
Alice, problem solving and dealing with a difficult situation was shown by the
manager at the centre where she attends aerobics classes when he compromised
with Alice that she could both still attend the aerobics class as well as go to
a local AA group. Meaning that she could both receive the support she needed
and still take part in recreational activities. Also showing negotiation skills
as well as the manager started by saying she could attend the alcoholics
support group instead of aerobics, however after discussing it with Alice he
allowed her to carry on attending aerobics while also going to the AA meetings.

The
only personal skill not shown is a sense of humour. This is missing from both
the people in the case studies and those around them. This could possibly be
due to the fact that these were serious problems and needed to have a
professional mind-set at all times. However that is not to say that healthcare
professionals should not have a sense of humour as it allows a more personal
connection between the service user and the staff. This helps when making care
plans and the user being more open with the staff they are with as they feel a
closer connection. It also helps to relieve the stress from a bad situation,
e.g. a negative diagnosis, putting the service user at ease and helping them
through a tough time.

Attachment
and resilience often go hand in hand and support each other. Connie Rees stated
that “The attachments of both child and parents affect children’s physical,
psychological, behavioural, and developmental wellbeing.” ncbi.nlm.nih.gov, 2007 and goes on to say that a lack of a
secure attachment at a young age to a care giver can result in physical and
mental ill health later in life and argues that although attachment throughout
life is important, it is most crucial in the earlier years of development, most
noticeably a call and response type of attachment where a baby or caregiver
will make an expression and the other will respond with something similar,
making a social attempt with eachother. This promotes healthy communication and
helps the child’s mind to form better with less chance of mental illness.

The triangle of care acts as a framework for health and
social care services in how they should communicate with patients and
professionals. This is important as it allows for a more diverse range of care,
meaning that the service user is more likely to get successful help and the
carer is able to pass information to more specialist people who can give advice
or give separate support. An example from the case studies would be Nusrat. In
the case study it is said that her and her main carer (her mother) converse
with the staff at the community centre. Later it is said that the centre
contact people more specialised in epilepsy and learning disabilities who would
likely provide separate treatment but converse with both the people at the centre
and Nusrat and her mother in order to improve the care she receives.

Although the triangle of care was used in each case study I
chose to use Nusrat’s one as an example as she had the most recognisable and
obvious existence of the triangle of care.

Johannes Volkelt was a German philosopher who framed
empathy as if you could understand what someone is trying to portray such as a
piece of art but only if your personality coincided with it. For example if you
are a calm person and looked at a calm painting such as a beach, then you are
likely to extract and feel emotions from the art piece, whereas if you were a
violent or hyperactive person you would not be able to feel the emotions trying
to be portrayed but may understand what the artist was trying to show. This can
relate to people as well. For example if someone has recently lost a relative
and you have lost one in the past, you would understand what they are feeling,
meaning that you have empathy for that person.

All of this ties in with anti-discriminatory practice
within health and social care. As attachment, the triangle of care, and empathy
all relate into caring for people, and without one of these then it is likely
that the other two will not be as effective (although empathy could be changed for
sympathy). An example for one of these failing could be discrimination e.g.
Discrimination because of sexuality.

If a service user is discriminated against by a carer then
they are less likely to form an attachment. This would lead to a lower chance of
the service user discussing problems openly with the carer which would lead to
the carer not looking for professional help for a problem or condition that
they are not trained to deal with such as epilepsy. This in turn would lead to
a lower quality of care for the service user and they would be less likely to
look for support in the future.

It is important that no person is discriminated against in
health and social care, whether it is staff, a service user, or a carer as they
all need to work together in order to give a good quality of care. However
there is no way of guaranteeing that there will not be discrimination so it is
equally important to have anti-discrimination procedures such as a complaints
procedure where people’s concerns are looked at and resolved, or advocacy
services where those who cannot speak for themselves are able to get their
voices heard. Patrick Green, Nusrat Patel and Alice Fernandez all had people
who acted as advocates in one way or another for them. And without these advocates
none of them would have been able to get their voices heard, whether it would
be because they were ashamed or could not think coherently. However since
people did advocate for them then they all received a higher quality of care
and were included in decisions about how they would be treated.

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