Person-Centred Care, What is it and is it being Practiced


More and more we are hearing about person-centred care, but, what is it?

What is person-centred care and why is it important?

So, ‘person-centred care is a way of thinking and doing things that sees the people using health and social services as equal partners in planning, developing and monitoring care to make sure it meets their needs.’

But, as a means of expediency systems are created and we are all expected to fit in with these systems, but fitting in for the sake of the system and expediency is not person-centred care for it is following the old way of institutional care.

One Definition institutional care

‘Institutional care’ is a type of residential care for large groups of children. It is characterised by a one-size-fits-all approach according to which the same service is provided to all children irrespective of their age, gender, abilities, needs and reasons for separation from parents.

But, it is not just for children as it can and is for everyone, so another definition is

Institutional care Definition – Law Insider, which states ‘Institutional care means care provided in a hospital, skilled or intermediate nursing home, or other facility certified or licensed by the state primarily affording diagnostic, preventive, therapeutic, rehabilitative, maintenance or personal care services. Such a facility provides twenty-four-hour nursing services on its premises or in facilities available to the institution on a formal prearranged basis.’

In other words, institutional care, is following the way of ‘one fits all’, but we are not objects, we are human beings and as such, we are all individuals and we should be seen as individuals wherever we are.

But, to allow everyone, all the time, to receive person-centred care, may not , while right, may not be cost effective and could considerably increase the cost of care. In the UK we have the NHS for health care, which in many instances is ‘standardised’ for the ease of running a large organisation, especially when one is in hospital, as it is ‘free at the point of delivery’. If, we are looking for more individualism and priority then we could always choose private funded care, where some forms of person-centred care could be available, but not always.

However, private care is expensive to the individual and many of us don’t have the financial means to have that choice.

But, that should not mean that some forms of person-centred care should not be available. Being more informed of the care could be one area. On admission we will be advised on some aspects, such as, meal times, but, perhaps, not when a doctor may be available to enable a conversation about the care to be given, even down to your medication, if any, will be dealt with. One of my own objections is not being consulted on any changes to my current medications and only aware of any changes when medications are given, which will follow the hospital ward routine and not how I usually administer my own medication. Much is said about a persons capacity, but when in hospital ones capacity to administer their own medication is ignored, even though no test of capacity has been conducted. Surely, any changes should be discussed with the patient and not, just changed by a doctor, who at the time, may not even have seen the patient, let alone talked with them about anything.

But, the same is also done for DNR’s (Do Not Resuscitate) which can and are placed on a patients record with no discussion and that is a ruling on life and death, when we are advised that doctors are not allowed to do euthanasia, but have done in the past and currently do. some years ago there was the ‘Liverpool Pathway‘,

However, there were methods before LCP and more than likely even now, hence the question about DNRs

So, even in dying there was a lack of person-centred care, and with all this there could certainly arise a question of trust in care.

But, in home care what is stopping person-centred care, well for one finance another an insufficiency of carers and maybe a lack of quality training, understanding and commitment in some instances.

The lack of funding is by far a major reason, followed by lack of quantity of care staff, which could lead to poor quality care being delivered. But, really good quality care should be there at all times and the majority of carers will provide good quality care, but good quality means differently to carers and those being cared for. Arriving on time and providing care to the care plan could be one definition of good quality care. But, in the care plan should be respecting choices of the person receiving care and what may have been so yesterday, may not be today, as when receiving care our ability to change is not withdrawn and our mood or preference may change from day to day and the delivery of care should reflect this be it in the care plan or not. A care plan should not be ‘written in stone’ and while reviewed at regular intervals say, 6 months, should also reflect choices on a day to day basis, which would be recorded in the daily record sheets.

Much more needs to be done and seen to be done around person-centred care for this is how care should be.

Create a new permanent bank holiday | 38 Degrees


I have signed this petition as the UK is low on the number of Bank Holidays, but unfortunately these are not recognised as such by some professions such as care.
Care is a 365 day profession and due to the complete lack of required finance and lack of persons in the profession, carers are expected to work these Bank Holidays as though they are normal working days. While working them does not affect their holiday entitlement, they are not paid any extra for doing so, with the possible exception of Christmas and New Years Day. So not only are the salaries they receive way too low, many not even on the Real Living Wage of £9.90 per hour, as most will be on the National Living Wage of £9.50 per hour.
This is far from encouraging people to enter the profession for such an essential workforce, when they could easily earn £14 per hour in supermarkets for much less responsibilities.
So while this holiday will benefit most of the population it will not benefit care workers, who will still only get the bare minimum holiday entitlement.
Everyone should receive the same basic holiday entitlement with Bank Holidays in addition.
This Government could do much more for Social Care, but they are very reluctant to provide funding.
Yes, there is the promise of a proportion of the £12 billion being raised from the from 6 April 2022 to 5 April 2023 National Insurance contributions increase by 1.25 percentage points. They say this will be spent on the NHS, health and social care in the UK, but initially the NHS will get the bulk of it to reduce the waiting lists, so, I feel little will be available for Social Care if any. The response of this Government during the COVID pandemic is a true refection on their view of Social Care, where they let down Care Homes. They promised there was a ‘ring fence’ around care homes , but, if there was it was full of holes as they instructed hospitals to discharge elderly patients into care homes without any COVID tests being done, hence COVID came into the care homes and this resulted in many deaths of residents and some care workers in the region of 20000.

But care homes are just one area of social care as care covers both children and adults for home care, respite, supported living, hospices, etc.

In fact, Social Care needs , at least, £12 billion itself and that would only bring funding back to the 2010 level, which was wholly insufficient then. For Social Care has never been sufficiently funded and every delay in funding brings greater pressures on the NHS.

Source: Create a new permanent bank holiday | 38 Degrees

Under my leadership, Labour’s commitment to Nato is unshakable | Keir Starmer | The Guardian


Our party was foundational in forming the postwar alliance, which – as Ukraine shows – remains essential today, says Labour leader Keir Starmer

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That is all well and good, but it goes deeper than that for NATO is not there as an attacking force, as muted by Putin, but at times the American influence does muddy the water. As it should be seen as a defence force and peacekeeper, in some respects as the UN forces, but, unfortunately, the UN is relatively inoperable not only due to the American influence, but also to that of Russia and China, so the UN Security Council is far from it.

But NATO can be misused due to American influence and the puppet attitude of some, at least former UK Governments. Unfortunately, Prime Ministers do not use their power as they should do, as was evident with Blair and his ‘weapons of mass destructions within 45 mins’, for which he didn’t really suffer any punishment for and went on to make more fortune in his life after his premiership. Let’s do hope that Boris does not follow this lead with his ‘No. 10 Parties.

In forming NATO it could have been better created and as the NHS is great, it could or should have been better funded as should Social Care, which should have been and still should be included as an integral part of the NHS.

Politics and world affairs are no way what they should be, so lets do hope that Putin’s actions are not the end of the World and he sees sense and does not invade Ukraine.

Source: Under my leadership, Labour’s commitment to Nato is unshakable | Keir Starmer | The Guardian

Real Living Wage rises to £9.90 an hour – BBC News


While this is good news for those on the Real living Wage, there are many more that are not, for they will be on the lower National Living Wage of £8. 91 per hour or the even lower National Minimum Wage of £8.36 per hour for those under 23 years. It will not be until 1 April 2022 that those on the National Living Wage will receive £9.50 per hour, with hopefully a corresponding increase for those on the National Minimum Wage.

Even though there is the National Living Wage is it in reality sufficient for persons to reasonably live on and are the persons on it really being paid what they are worth. You only have to compare care workers in the care profession to those employed in supermarkets and Amazon, where , I believe they can earn from £14 per hour and need less skills and undertake less responsibility than care workers.

Many in the Care Profession are on anything between the National Minimum Wage and the National Living Wage, with the majority nearer the National Minimum Wage than the National Living Wage.

This is mainly due to the Government policy in funding Local Authorities, (LAs) and as most of you will be aware LAs from 2010 were subjected to austerity cuts and to date these cuts have not been reversed and LAs are still having to find savings to accommodate this serious underfunding and many vital LA services are suffering as a result. You may wonder why this is affecting the care profession, well many care providers are funded by LAs so that the care providers can pay their care workers to provide the care needed by vulnerable people. There are what are called ‘self funders, but in reality they are only small percentage wise, for these are people who have been assessed as having sufficient income and capital to fund their own care, so they pay the care providers directly.

Care is in dire straits for many reasons, the lack of funding being one, but there is also a large deficit in the numbers of people wishing to come into care pay is one reason, but there is also working conditions, no sick pay, career progression and much more.

Conditions in care need to be considerably improved, but this requires much more funding which the Government could solve, if they wished to.

The Government could also relax the immigration regulations to allow more persons to come into the UK to go into the care profession, which they have done in other areas.

But then for this to occur you need a Government that really cares, which this Government have proved with their actions and also their inactions, that they do not. All they care about is themselves and their rich donors to the Conservative Party.

The Government say they wish to safeguard the NHs, but there abandonment of the care profession is also causing many strains on the NHS as lack of care is causing more to need NHS services and the lack of care available is then delaying hospital discharges.

So, in affect the Government don’t really care about the NHS only in ‘words, but not ‘actions’.

 

 

Source: Real Living Wage rises to £9.90 an hour – BBC News

Fury At ‘Do Not Resuscitate’ Notices Given To Covid Patients With Learning Disabilities


For this practice to have recurred in the second wave of the pandemic when it was highlighted in the first is extremely worrying, for it needs the dreaded phrase ‘lessons will be learnt’ to be utter again. For, lessons, it appears are never learnt, for to be learnt there must be a willingness to learn, from which it is evident that the willingness is not there, and I do doubt will ever be.

For this stems from the practice in health and many other areas for ‘we know best’ and that it is of no concern that patients and their families are not worthy of being considered.

This centres on the belief that the system is sacrosanct, and people affected are of no concern.

Whereas the person should be at the centre, self-centred care, should be central as the system should fit the person and not the person the system. If it is not possible to achieve then the system needs to be altered to ensure it is.

For, far too long health and also Social Care and other areas feel they are too important to change and therefore the person at the centre is virtually ignored.

If it was not for persons, then health and social care and other areas would not be required. Each person is different and therefore it should not be assumed the practice of ‘one fits all’ is how it should be.

All systems must be flexible to change as and when required with ease and quickly be adaptable.

Unfortunately, there is much disregard with people and organisations for the opinions of people who feel they need to be considered. But their opinions are important and should be listened to for they are endeavouring to make things better for everyone.

Same Difference

People with learning disabilities have been given do not resuscitate orders during the second wave of the pandemic, in spite of widespread condemnation of the practice last year and an urgent investigation by the care watchdog.

Mencap said it had received reports in January from people with learning disabilities that they had been told they would not be resuscitated if they were taken ill with Covid-19.

The Care Quality Commission said in December that inappropriate Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) notices had caused potentially avoidable deaths last year.Advertisementhttps://eb3ca1ecd275ae49142ae247f5e428af.safeframe.googlesyndication.com/safeframe/1-0-37/html/container.html

DNACPRs are usually made for people who are too frail to benefit from CPR, but Mencap said some seem to have been issued for people simply because they had a learning disability. The CQC is due to publish a report on the practice within weeks.

The disclosure comes as campaigners put growing pressure on ministers to reconsider a decision not…

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Maskless crowd ‘chant ‘Covid is a hoax” outside St Thomas’s Hospital | Daily Mail Online


This is disgraceful and shows why the COVID-19 pandemic is progressing.

While I agree with ‘Freedom of Speech, it needs to be legally curtailed when it infringes the Freedom of others.

It is showing complete disrespect for our health service and all health service workers, while, not only putting themselves at risk, but more importantly the lives of others.

 

Source: Maskless crowd ‘chant ‘Covid is a hoax” outside St Thomas’s Hospital | Daily Mail Online

How teenagers ended up operating crucial parts of England’s test and trace system | George Monbiot | Opinion | The Guardian


As one whistleblower tells me, a vital public health service is being bungled by private contractors, says Guardian columnist George Monbiot

Source: How teenagers ended up operating crucial parts of England’s test and trace system | George Monbiot | Opinion | The Guardian

The NHS taking over social care would be a disaster. Make services truly local instead | Social care | The Guardian


Covid-19 has exacerbated the social care crisis – but a national service isn’t the answer

Source: The NHS taking over social care would be a disaster. Make services truly local instead | Social care | The Guardian