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Supporting Guidance Standard 6.1

Health and Care Standards

Supporting Guidance

Standard 6.1 Planning Care to Promote Independence

 

What is the Standard about?

Health services treat people as individuals, in a way that reflects their needs, and enables them to maintain their independence.

Organisations and services should ensure that all patients within their care in all settings, including those provided through contractual arrangements receive individualised care plans that recognise their differing needs. The organisation will have to work with a range of partners to meet these needs. 

Patients receiving secondary mental health services are subject to the Mental Health (Wales) Measure 2010 and must have a statutory outcome focussed care and treatment plan that must be regularly reviewed.  A Code of Practice has been issued to give guidance to the providers of these services in health and social care.

This standard is about providing all aspects of care in a timely, appropriate and sensitive way and promoting self-care.

Ultimately this standard is about ensuring that all patients and service users are treated in the right way, at the right time, in the right place and with the right staff.

 

Who is it for?

All individuals and health services in all settings.

In relation to the standard criteria (in bold) the following key questions need to be considered:

People are supported to engage and participate in their care and feel valued in society

  • How do you support individuals to be involved in discussions about their care?
  • Do patients understand the information they have been given?
  • How do you ensure that people with different communication and information needs, for example, people with sensory loss, people whose first language is Welsh, people whose first language is not English or people with learning disabilities, are met so that they can participate in discussions about their care
  • How do you ensure that you communicate and provide information in a way that is accessible to the individual?’
  • How do you ensure that you are acting in accordance with the All Wales Standards for Accessible Communication and Information for People with Sensory Loss?
  • How do you ensure that you record patients’ individual communication needs, and share this information appropriately when referring onwards?
  • How do you ensure that staff are trained to support the different communication and information needs of people and those with sensory loss?
  • How do you ensure patients have access to advocacy services when required or needed?

People are treated with the understanding that they have the right to be who they are, to be understood, considered and recognised as an individual.

  • Do you ask patients about their preferred means of communication and if they require any support? For people with sensory loss this may include:
    • asking what format they require written communication
    • ensuring they can access instructions for taking medication
    • checking on arrival if they need their name called for an appointment
    • the need to lip read,
    • access to assistive equipment,
    • the need to maintain hearing aids or
    • access to British Sign Language interpreters.

Sufficient time is available to support and encourage people to care for themselves, and supporting carers where individuals are unable to care for themselves.

  • How do you ensure that sufficient time is available to support people with communication needs in an appropriate and sensitive way that preserves their privacy and dignity?
  • How do you ensure that sufficient time is available to support people with different communication needs?
  • How do you take into account additional support that people with sensory loss may need to care for themselves?

Support is given to ensure that people have the right to make decisions about their life.

  • How do you ensure that people with different communication needs and/or sensory loss have equal access to information to ensure they can make informed decisions about their life?
  • How do you provide support for people with different communication needs and/or sensory loss to participate in discussions and make informed decisions about their life?
  • How do you ensure that you record patients’ individual communication needs, and share this information appropriately when referring onwards?
  • How do you ensure that people including those with sensory loss have heard and understood everything they need to know about their healthcare?

The care that people receive will respect their choices in making the most of their ability and desire to care for themselves.

  • How do you support people who have lost the capacity to make some or all decision about their care and treatment to be as involved as possible?

Ongoing assessment and individual care planning involving all those relevant to the person’s care, forms the basis of the plan of activities and care. This takes account of the person’s requirements, strengths, abilities and potential.

  • How do you ensure that patients understand the information they have been given and are able to fully participate in care planning?
  • How do you ensure that people with different communication needs are able to give informed consent to decisions about their care 
  • If the patient has sensory loss, how do ensure that you are acting in accordance with the All Wales Standards for Accessible Communication and Information for People with Sensory Loss?
  • How do you ensure the patient has a care plan in place (either written or verbally agreed in their notes) which identifies how they will get support to manage their condition, achieve a better quality of life, in line with their personal needs and aspirations?

Patients receiving secondary mental health services subject to the Mental Health (Wales) Measure 2010 must have a statutory outcome focussed care and treatment plan that must be regularly reviewed. 

  • How do you ensure that you involve patients and when appropriate their families or carers in the development and treatment plans and that they are regularly reviewed?

Where possible, people are shown different ways of doing things to help them to be independent.

  • How do you seek specialist advice and/or advocacy support to ensure that people with different communication needs, sensory loss or who lack mental capacity are supported to develop new skills to enable their independence?
  • Is a patient diagnosed with sight loss referred to their Eye Clinic Liaison Officer or able to access re-enablement/rehabilitation as quickly as possible?

If appropriate, people are offered equipment to help them walk, move, eat, hear and see. This equipment is well maintained, and if provided for a specific person is kept for their own use.

  • How do you ensure that equipment is provided in a timely way?
  • How do you ensure that people are trained and able to use this equipment?
  • How do you ensure that equipment provided is appropriate?

People’s ability to care for themselves is fostered and their NHS/care environment is as accessible, comfortable and safe as possible.

  • How do you use colour contrast in the interior design to make the environment safer for people with low vision?
  • How do you ensure signage and way finding is clear and accessible?
  • Are lifts accessible and audio enabled?
  • Are environments clear from obstacles?
  • Where there are visual display systems, how do you ensure people with sight loss can access the same information/systems?
  • Are there induction hearing loops installed to enable people who use hearing aids to hear
  • Are staff trained to use and maintain the hearing loop system
  • Are there accessible toilets?

People are encouraged to be active taking appropriate exercise and/or recreation as far as their condition allows.

  • How do you ensure that assistance is available, for those who need it, to enable them to take appropriate exercise/participate in recreation?

Healthcare workers are sensitive to people’s linguistic needs and people will receive services through the medium of Welsh as a natural part of their care. People are shown respect for their cultural identity and are able to access Welsh language services without any obstacles, although not everyone responsible for their care will speak Welsh.

  • How do you ensure the communication and information needs of an individual whose first language is not English are met?
  • How do you ensure your staff know how to access to interpretation and translation services?
  • Are the individual preferences for Welsh language services identified and taken into account?
  • Is the environment supportive and inclusive for Welsh speakers – e.g. bilingual reception area; Welsh language signage and written information; Welsh language radio/ TV / newspapers/magazines?
  • Do you make an ‘active offer’ (providing services in Welsh without someone having to ask for it) when providing information to Welsh speakers?

Public information will be easily accessible to ensure people take responsibility to access care appropriately.

  • How do you ensure public information is accessible to people with different communication and information needs? 
  • Is information provided in a range of accessible formats including Large Print, Braille, Audio, British Sign Language (BSL) and Easy Read?
  • How do you ensure your website is accessible for people with different communication, sensory loss, information and language needs?
  • How do you ensure that you are acting in accordance with the All Wales Standards for Accessible Communication and Information for People with Sensory Loss?

There is effective transition from children to adult services.

  • How do you ensure that children and young people are correctly identified as entering transition?
  • How do you ensure the correct professionals are involved during the transition to young adulthood?
  • How do you ensure that children and young people express their wishes and preferences about their services, especially where there are communication deficits?

Health, personal and social care needs are assessed and set out in regularly reviewed plans of care agreed by the individual and the people caring for them. The plan is only shared with others with the service user’s consent.

  • How do you ensure care plans are regularly reviewed?
  • How do you ensure that people have access to their individual care plan?
  • How do you ensure that individuals can access their care plan in a format accessible to them?

People are supported to get help, when they need it in the way they want it.

  • How do you ensure that any information or communication needs are supported when people need to access help?

Support is provided to develop competence in self-care and promote rehabilitation and re-enablement; and achieve effective partnership working with other services and organisations, including social services and the third sector.

  • How do you support your primary care clusters to draw in all local partners, such as the third sector and local government, to deliver local solutions and strategies to improve the health and wellbeing of the local community, help prevent avoidable ill health and provide ongoing care for people living with long term conditions or who are frail and elderly?
  • How do you promoting the use of volunteers within your organisation?
  • How do you work with local authority sensory services teams to promote timely access to specialist rehabilitation for people with sensory loss?
  • How do you support patients, service users and carers to understand what is proposed for their:
    • treatment and care,
    • rehabilitation, and
    • re-enablement?
  • How do you promote and support self-care?
  • How do you involve patients, service users and carers in discharge planning?
  • How do you involve patients, service users and carers in decisions about resuscitation?
  • How do you ensure effective care planning and provision for patients with chronic conditions in line with national delivery plans where applicable
  • How do you identify potential partners to support individual patients, service users and carers?
  • Do you have effective working relationships with your partners? If not, what steps do you take to improve them?
  • Do your working relationships with Third Sector organisations comply with the terms of local compact agreements?
  • How do you know that you partner organisations have done what they said they would do?

Health services will work with community groups for example those who can help support people with protected characteristics.

  • How do you identify potential partners, third sector or community groups to support individual patients, service users and carers and ensure that service providers understand and are able to respond to the diversity of their local population?
  • Do you have effective working relationships with your partners? If not, what steps do you take to improve them?
  • Do your working relationships with Third Sector organisations comply with the terms of local compact agreements?
  • How do you know that your partner organisations have done what they said they would do?

 

Legislation and Guidance

 

Service Development and Commissioning Directives

 

Toolkits

 

Useful Contacts

 

Good Practice Guides