What is Confidentiality in Childcare?

Confidentiality refers to keeping sensitive, personal information private and secure. This means not disclosing personal information to people who don’t need to know it, preventing unauthorised access to private information and not using, sharing or disclosing someone’s information without their consent.

In terms of confidentiality in childcare, confidentiality is an agreement between members of staff, health and social care professionals, children and their families. We all have personal information – even children – and we all have a right to privacy. Therefore, you have an important role to play in keeping sensitive information private and only sharing it when absolutely necessary.

In childcare settings, confidential personal information is anything about a child or their family that could be considered ‘sensitive’. Legally, personal information is anything that relates to an identifiable person, isn’t common knowledge, and that would cause the person damage, harm or distress if it was disclosed without consent.

For children and families examples of personal information that you should keep confidential include:

• The child’s name, address and contact details.
• Registration forms or contracts.
• The parents’ or carers’ names and contact information.
• Parental consent forms.
• Information about a child’s health, disabilities or wellbeing.
• Details about a child’s development or educational needs.
• Notes containing child protection or welfare concerns.
• Accident and incident records.
• A child’s medical history.
• Photographs of the child.

Why is Confidentiality Important in Childcare?

Confidentiality is important in childcare because not only do you have a duty of care towards the children you look after, but you are also responsible for legal compliance. We all have a legal right to privacy under Article 8 of the Human Rights Act 1988 which establishes ‘the right to respect for your private and family life’. To help uphold this right, you must keep children’s information confidential and only share it when absolutely necessary.

You also have a legal duty to keep a child’s information confidential under the Data Protection Act 2018. This law requires all settings to:

• Keep personal information safe and secure.
• Protect personal information from misuse.
• Process personal information securely and confidentially.
• Give people control over the use of their personal data (ask for consent).

Alongside legal reasons, confidentiality in childcare is essential because it establishes trust between parents, children and childcare workers. If parents and carers can trust that their child’s information will be kept secure, then they’re more likely to trust you and your setting with important information and less likely to withhold details from you.

How to Maintain Confidentiality in Childcare

To maintain confidentiality in childcare, you must take into account the following:

• Only share personal information with third parties when you have the consent and formal permission from the child’s parents or carers or, where appropriate, the child. Information can only be shared without consent in emergency situations.
• When keeping records about a child, whether digital or on paper, the personal information recorded must be accurate and factual. Avoid vague language, judgmental comments or opinions.
• Ensure parents and carers are informed about which personal information you need about them and their children, what you’ll be using it for and how you’ll keep it safe and confidential.
• Personal information should only be shared on a ‘need to know’ basis, i.e. only with people directly involved in the child’s care.
• When talking to a parent, carer, child or adult involved in the child’s care about sensitive topics, or when requesting personal information verbally, hold the discussion in a private space where you cannot be overheard.
• Parents have a legal right to see what has been written about their child and make an access request to see their files. However, if the child’s files contain confidential information about other people, then these people must be asked for consent before you can share the file.
• Your setting must have robust data protection and GDPR policies and procedures in place for all types of confidential information, whether digital or paper. This includes clear guidance on obtaining, storing, sharing and deleting personal information,
• All members of staff in your childcare setting need to be trained in confidentiality, your setting’s policies and procedures and their responsibilities. Everyone must understand how to handle confidential information and how to keep it secure.

Looking to Learn More?

Everyone working in a childcare setting should understand the importance of confidentiality, data security and how to handle personal information about the children and families they work with. Our online GDPR Training, Data Protection Training, Cyber Security and Information Governance courses will ensure you and your staff members have all the necessary knowledge to act responsibly and legally.

When Can Child Confidentiality be Breached?

The law states that personal information must be kept confidential and, for childcare practitioners, confidentiality in childcare is an essential part of the role. However, there are certain situations when confidentiality can be breached and parental consent is not needed to disclose information.

The Children Act 2004 says that childcare professionals must share information about a child if:

• There are immediate concerns about a child’s physical or mental health.
• The child is being exposed to harm or is at risk of harm.
• Parental needs mean that the child cannot be looked after properly.

Confidentiality should always be set aside if there is an immediate risk of harm to the child, yourself or someone else. This is also the case if the child is at risk of being involved in criminal activity. In these situations, consent to share personal information is not required as the child’s immediate welfare is more important.

Confidentiality Policy in Childcare

A confidentiality policy in childcare is used to clearly outline the procedure for collecting, storing and sharing personal information. It should be communicated to all members of staff, parents and carers, so that everyone understands what their responsibilities are.

Your childcare setting should also have a separate data protection policy and safeguarding policy that reference confidentiality and information sharing.

A confidentiality policy in childcare should cover:

• What types of personal information your setting holds.
• Where you will store personal information and how you will keep it secure, e.g. a locked cabinet, password protection, etc.
• Who the personal information will be shared with.
• How parents can access information about their child held by the setting.
• The procedure for unauthorised breaches of confidentiality.
• An explanation of when personal information will be shared in case of emergency.
• Who has overall responsibility for data protection in the setting.
• How staff members will be trained in confidentiality procedures.

Confidentiality in childcare is essential for upholding legal rights, data protection compliance and child wellbeing. All personal information that’s shared with your setting must be kept private and secure, and this can be done by following a robust confidentiality policy. Everyone must understand their responsibilities and recognise what they should be doing to maintain and respect the confidentiality of the children and families they work with.

Further Resources:

• Information Governance Training
• Whistleblowing in Schools: Policy and Procedure
• Creating a Safeguarding Policy – Example Template for Schools
• Keeping Children Safe in Education: Key Changes

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What is Independence in Health and Social Care?

Having independence in health and social care means having control over your own life and your own decisions when in a health or social care setting, whether it’s control over which food to eat, what activities to join in with or which care option to choose.

Independence means a person is respected as an individual, isn’t subject to the authority of someone else and is always given the support they need to voice their own preferences.

Autonomy is important in health and social care settings as, by their nature, these places can often make residents and patients feel as if they have little control over what’s happening to them. Independence enables people to maintain as much autonomy as possible whilst in these settings.

All residents and patients are individuals with their own, unique views, preferences and experiences – and they all deserve to be treated in this way. Even if the person has reduced capacity, they should still be given as much control as possible and promoting independence will help them to feel included, respected and empowered.

Why is Promoting Independence Important in Health and Social Care?

As well as helping people to feel more in control of their lives, promoting independence in health and social care settings brings many other benefits, to patients, residents, members of staff and the setting as a whole. Here are 10 reasons why promoting independence is important in health and social care:

1. Under the Care Act 2014, all services should aim to keep people well and independent. Empowerment – including independence and person-centred care – is a key principle under the Act, making it a legal requirement as well as a moral one.
2. Because independence increases wellbeing, confidence and autonomy, it has the power to delay future care needs, therefore reducing the burden felt by services and families.
3. Independence enables a better quality of life for the individual, as freedom, confidence and better mental health means more sense of purpose and less chance of loneliness, as they are more likely to join in and continue to be social.
4. Promoting independence in health and social care means that residents and patients are able to do things independently, which enhances their confidence, self-belief and self-image.
5. Independence empowers residents and patients to have a say in their own care, support and treatment, make their own choices and have their voices heard. In turn, this enhances dignity and respect for the individuals.
6. Increased autonomy means reduced dependency on staff and facilities in health and social care settings. If individuals can do as much as possible by themselves, the demands on carers and nurses are lessened.
7. Independence can help to reduce or slow physical and mental decline. Keeping the brain active has been shown to improve wellbeing, alertness, memory and concentration.
8. Promoting independence in health and social care reduces isolation and loneliness and increases a sense of belonging, as confident, independent individuals are more likely to take part in social activities. Loneliness in the elderly is shown to contribute towards further health problems, so it’s important that it’s avoided.
9. Independence empowers people to feel in control of their health and wellbeing, making them more likely to take action if they feel unwell. Therefore, independence can act as a preventative measure against worsening illnesses and conditions.
10. Independence reduces the chances of resistance to care. If patients and residents feel more in control of their life, they’re less likely to refuse healthcare assistance because they understand why it’s needed.

How to Promote Independence in Health and Social Care

Promoting independence in health and social care, whether it’s patients, elderly residents or people with disabilities, is closely linked with person-centred care. This means personalised care planning that focuses on each person as an individual and takes into account their particular needs and preferences. Our article on Why Person-Centred Care is Important will give you more guidance on this topic.

An easy way to promote independence is to enable the person to take part in activities and hobbies that they enjoy. For example, craft clubs, reading groups, gardening, watching TV or painting are all activities that most care settings are able to provide and which can bring patients and residents a lot of freedom and joy. Our article on Activities for Care Homes will give you some good ideas.

You should also promote independence by allowing the person to choose what they want to eat (or don’t want to eat), pick the time they want to eat (if practical) and select who they want to eat with (or decide if they want to eat alone). Additionally, enabling the person to have control over who they socialise with can be empowering for the individual.

In terms of a person’s healthcare, medication and support, promoting independence in care requires clear communication and active listening. Never assume that a person prefers a particular method of care or type of medication – always allow them to choose what suits them best wherever possible. Furthermore, all members of staff that care for the individual should be aware of the person’s individual preferences, so good communication between colleagues and care providers is essential. Our article on How to Improve Active Listening provides some great tips.

You can also promote independence in care by helping patients and residents to manage their own health and wellbeing. Alongside giving them control over their medication and support preferences, teach them about the importance of regular movement, a good diet, involvement in social activities and keeping their brain active. If a person is able to maintain their own health, they’re more likely to get better, have a better quality of life and even live longer.

Another idea is to help improve digital literacy amongst patients and residents. Technology plays an important role in modern day healthcare, so if residents and patients understand more about how to use it, they’ll feel more in control and more independent. For example, assistive technology and communication technology all enable a person to live more independently, but only if they fully understand how to operate them.

Promoting independence in health and social care is all about seeing the person as an individual, empowering them to make their own choices and helping them to do things for themselves. In turn, independence improves mental wellbeing, makes loneliness less likely, slows down physical and mental decline and gives a person more confidence and control over their lives. This is why promoting independence is so important for health and social care providers.

Further Resources:

• Introduction to Safeguarding Adults (Level 1)
• What is Person-Centred Care and Why is it Important?
• Using Technology in Health and Social Care
• Person-Centred Care Quiz
• 9 Ways to Help Promote Dignity in Your Care Home
• Risk Enablement: Making Safeguarding Personal

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What is Advocacy in Health and Social Care?

Advocacy in health and social care is when a patient gets support from someone else – an advocate – to help them express their views, wishes, feelings and concerns and to stand up for their rights on their behalf. Advocacy is required when the patient lacks the ability to do these things on their own (self-advocacy).

Advocates ensure a patient’s rights and best interests are upheld throughout their interactions with the health and social care system. They are an independent individual and act separately from the NHS, council and other healthcare services the person accesses.

An advocate can be appointed from a professional advocacy service or they can be a friend, family member or unpaid carer that the patient has chosen themselves. Note that paid carers cannot act as advocates.

In some situations, patients are legally entitled to an advocate. In England and Wales this is known as ‘statutory advocacy’ and includes:

1. Independent Mental Health Advocates (IMHAs) who support patients currently being assessed or receiving treatment under the Mental Health Act 1983.
2. Independent Mental Capacity Advocates (IMCAs) who support patients who lack capacity to make certain decisions under the Mental Capacity Act 2005.
3. Social care advocates who support patients who have difficulty understanding, retaining or using information, or who have difficulty communicating their views, wishes and feelings, under the Care Act 2014 or Social Services and Wellbeing Act (Wales).

What is the Role of an Advocate?

The exact role of an advocate in health and social care depends on the patient’s specific needs but, in general, they are there to support the choices, views, interests and wellbeing of the individual when it comes to decisions about their care. In all circumstances, the advocate should get to know the patient so they can truly support and represent them. 

The role of an advocate includes:

• Actively listening to the views and concerns of the patient.
• Helping the patient to find information they need.
• Discussing different options with the patient.
• Providing information in a format the patient can understand.
• Helping the patient to make informed decisions.
• Encouraging active participation wherever possible.
• Contacting people on behalf of the patient.
• Explaining the patient’s wishes and views to others.
• Making phone calls or sending emails on behalf of the patient.
• Accompanying the patient to appointments and meetings.
• Supporting, reassuring and empowering the patient.

On the other hand, an advocate cannot and should not:

• Make decisions on behalf of a patient without consulting them first.
• Tell the patient what to do.
• Give their personal opinion on what the patient should do.
• Make judgments about the patient’s choices, wishes and feelings.
• Make assumptions about what’s best for the patient.
• Argue with the patient if they disagree with their choices.
• Act in a manner that could surmount to discrimination.

Examples of Advocacy in Health and Social Care

There are many examples of ways an advocate can help support a patient in a health and social care setting, including:

• Accompanying the patient to their medical appointments to ensure they’re receiving the right care.
• Speaking to the patient’s doctor on their behalf, whether on the phone, in person or via letter, to explain the patient’s needs.
• Helping the patient understand the benefits they’re entitled to and helping them make claims or attend meetings.
• Assisting the patient to create a residential care home or nursing home plan and ensuring it matches their individual needs and wishes.
• Helping the patient with budget management and paying their healthcare bills.
• Carrying out a care needs assessment with the best interests of the patient in mind.
• Acting as a point of contact for the patient if a healthcare professional needs to communicate information to them.
• Explaining the different options available to the patient in a manner they can understand, such as options for residential care, appointments or medication changes.
• Speaking on behalf of the patient to make a formal complaint about the health and social care system, ensuring their rights are upheld.
• Representing the patient in meetings to ensure all their questions are answered, all points are covered, the patient is given all available options and the rights and dignity of the patient involved are upheld at all times.
• In the case of independent mental capacity advocates, making decisions about the patient’s care and treatment on their behalf and in their best interests.

Why is Advocacy Important in Health and Social Care?

Advocacy is an important part of many people’s health and social care arrangements as it enables them to maintain their independence, dignity and basic rights throughout all stages of the health and social care system.

Dignity in care is vital for patient wellbeing, as it helps people retain control over their independence whilst in a care environment. Having an advocate does not remove a patient’s control and should not restrict a patient’s independence: the advocate is there to support the patient and ensure their dignity, individuality and wishes are maintained.

Another reason advocacy is important in health and social care is because, under the Mental Capacity Act 2005, patients are given legal protection if they are unable to make their own decisions about their care because they lack capacity to do so. This might be because of a disability, mental health condition, illness or injury which makes it difficult to make informed choices about where to live and what medication to take, for example. These people are entitled to an independent mental capacity advocate (IMCA) who will represent the patient and support them in any decision-making processes.

How Can an Advocate Support an Individual?

The following top tips for advocates will help you understand more about your role as an advocate and how you can help support the person you’re advocating for:

1. Ask lots of questions – ask questions to the person you’re representing, to the people you’re speaking with on their behalf and to the healthcare professionals involved in their care. You can never know too much.
2. Be assertive – especially in meetings and appointments, it’s important that you stand up for the person you’re advocating for, fight for their views and ensure they are heard.
3. Communicate well – communication needs to be clear and regular between you, the person you’re advocating for and all healthcare professionals involved with the person. Effective communication in health and social care is about more than just the words you use, but also your body language, tone of voice and listening skills.
4. Know the system – ensure you’re familiar with the health and social care services the person uses, how it works and who’s involved. You need to understand everything about the person’s daily routines and experiences.
5. Document everything – it’s a good idea to keep a written or typed note of everything you’ve done on behalf of a person, including actions taken, decisions reached and information given, in case you need to refer back to it at a later date. Include names, dates and times of events.
6. Build relationships with everyone – it’s important that you have a positive relationship with the person you’re advocating for but also with the healthcare professionals they encounter. Get to know the names of the nurses, doctors, carers and therapists the person deals with to help you better support the person you’re working with.
7. Listen well – active listening means truly hearing what the person you’re advocating for is saying. Pick a method of communication that works best for them, whether that’s verbal or non-verbal, to ensure you’ve really heard their views and wishes.
8. Be creative and adaptable – advocacy can be challenging for everyone involved and it can require you to think on your feet to come up with new solutions and methods.
9. Follow up on everything – if you’ve spoken to someone or attended a meeting or appointment on behalf of a person, then ensure you follow up with them to ensure the agreed actions have been completed and the appropriate decisions have been made.
10. Remember there’s no right way to advocate – there’s no rulebook explaining exactly how to be an advocate, so often it’s up to you and the person you’re advocating for to come up with methods that work best for the both of you.

Advocacy in health and social care is when a person supports a patient to have their views and wishes heard and their rights upheld. A good advocate listens well to their subject and really gets to know them, so they can successfully represent them in meetings, appointments and in all decisions relating to their care. Advocates play an important role in maintaining a patient’s dignity and rights in all aspects of health and social care.

Further Resources:

• Safeguarding Online Courses
• What is the Mental Capacity Act?
• Restrictive Practices in Health and Social Care
• How Can We Work Together to Safeguard Adults?
• Safeguarding Adults at Risk: What is it and Who is it For?
• Risk Enablement: Making Safeguarding Personal
• Promoting Independence in Health and Social Care

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What is the Mental Capacity Act?

The Mental Capacity Act 2005 (MCA) is a UK law designed to empower and protect people in care who lack the capacity to make their own decisions. For example, choosing anything from what to eat and what to wear to deciding which care home to move to or whether to have surgery or new medication.

‘Mental capacity’ refers to a person’s ability to make decisions, whether in day-to-day life or one-off, more serious decisions about their care, treatment or finances. A person with good mental capacity is able to make choices, understand information about the choices and communicate their decisions. Someone who lacks mental capacity is unable to do these things, often as a result of illness, injury, a mental health condition or medication.

The Mental Capacity Act has a two-stage test to determine capacity:

1. Does the person have an impairment of their mind or brain, whether as a result of an illness or external factors, such as alcohol or drug use?
2. Does the impairment mean the person is unable to make a specific decision when they need to? People can lack capacity to make some decisions but have capacity to make others. Their mental capacity can also change over time.

In all situations, a person should be enabled to make their own decisions. They’re also allowed to nominate someone else to make decisions on their behalf if they become unable in the future, and this person should always be consulted if you need to make a choice on behalf of a patient.

If a person lacks capacity to make decisions, and you need to make a decision for them, then it must always be in their best interests. Section 4 of the Mental Capacity Act contains a checklist that outlines what you need to consider to ensure you’re acting in a person’s best interests:

• Consider a person’s past and present wishes, feelings, beliefs and values.
• Consider the specific type of condition, illness or injury the person has, how long it’s likely to last for and the person’s age.
• Consider if the person is likely to regain capacity to make the decision in the future. If so, postpone the decision until that point (wherever possible).
• Encourage the person to take part in the decision, doing whatever you can to help them be involved and to communicate in a way that works for them.
• Consider the views of the person’s family, carers or nominated person/s.
• Never make assumptions about a person that could be discriminatory, i.e decisions based on their age, disability, race or sex.

In specific cases, decisions may need to be made on behalf of a person which restrict their personal freedom. This is known as a deprivation of liberty and can only happen in very specific circumstances. If a deprivation of liberty is required, the care provider must first apply to their local authority for legal authorisation, as depriving someone of their freedom can infringe on a person’s basic human rights.

Who Does the Mental Capacity Act Apply to?

Everyone who works or cares for someone who may lack capacity to make decisions must comply with the Mental Capacity Act. This applies to all types of job roles in health and social care, including nurses, doctors, therapists, assistants, support workers, social workers and many more.

The Mental Capacity Act itself applies to all people aged 16 or over and who may lack capacity to make decisions for one or more reasons. This includes people with:

• An illness, such as dementia or stroke.
• A brain injury.
• A learning disability.
• A mental health condition.
• Unconsciousness, such as from anaesthetic or an accident.

These conditions don’t necessarily mean a person lacks the capacity to make all decisions. In some instances, they may be unable to make specific decisions but are able to decide on others. For example, they’re able to choose their clothing but unable to choose their care environment. The key is to never assume someone lacks capacity and never to make all decisions on behalf of a person.

The Mental Capacity Act defines someone as ‘unable to make a decision’ if they cannot:

• Understand the information relevant to the decision.
• Retain information to make a decision.
• Use or weigh up information to make a decision.
• Communicate their decision in any way.

5 Principles of the Mental Capacity Act

There are five principles of the Mental Capacity Act that must be considered before any action is taken on behalf of a person. The five principles are:

1. Always assume a person has the capacity to make a decision, unless it’s proved otherwise.
2. Always help people to make their own decisions wherever possible. Support the person in all ways you can to make the choice themselves.
3. Never assume someone doesn’t have capacity to make a decision, just because you think their choice is wrong or unwise.
4. All decisions made on a person’s behalf must be in their best interests.
5. Always opt for the least restrictive alternative if a decision needs to be made on someone’s behalf.  Decisions must not restrict someone’s basic rights or freedoms and, where there are multiple options, the least restrictive option must be chosen.

If you work in health and social care, then an understanding of the Mental Capacity Act is an important part of your role. People who lack capacity must be fully supported to make their own decisions where possible, and you should only ever make choices on their behalf if everything else has been tried first. As a caregiver, acting in a person’s best interests is one of the most important things you can do, and this includes empowering them to make their own decisions.

Further Resources:

• Introduction to Safeguarding Adults (Level 1)
• Restrictive Practices in Health and Social Care
• How Can We Work Together to Safeguard Adults?
• Safeguarding Adults at Risk: What is it and Who is it For?

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What is Restrictive Practice?

A restrictive practice is an action that prevents a person from doing something. They’re often used in health and social care settings to keep patients safe from something that may cause them serious harm or distress and are also known as restraints.

Restrictive practices can be controversial as they can often stop a person from doing something they want to do, or can be seen as controlling. For this reason, there are strict rules around when restrictive practices can be used and they should only be used as a last resort. They should never be used to punish someone, control someone or handle difficult behaviour.

A restrictive practice should only be used if:

• It’s needed to keep someone safe.
• It’s done for the right reasons and in the right way.
• The patient is fully involved in the decision.
• The practice is used for the minimum amount of time possible.
• The practice is regularly reviewed for effectiveness and suitability.
• The patient’s human rights are upheld.
• All other options have been tried first.

Types of Restrictive Practices

There are many different types of restrictive practices that health and social care settings may opt to use depending on the particular patient and the dangers present. Remember, a restrictive practice must only ever be used as a last resort, after consulting with the patient and in a manner that upholds a patient’s basic human rights. Below are some restrictive practices examples:

Blanket restrictive practices

Blanket rules are when everyone is treated the same and a restrictive practice applies to all patients in the setting, rather than to individuals. Blanket rules often restrict a person’s liberty. For example, requiring all patients to have their lights turned off for bed at the same time or not allowing anyone access to their own medication. Instead, an individual risk assessment should be done for each person and restrictive practices only applied on a case-by-case basis.

Chemical restrictive practices

A chemical restriction is when medication is used to keep a patient safe from harm, often to subdue violent behaviour. This is in addition to any drugs the patient is on for a health condition. For example, using sleeping tablets or injections to send someone to sleep or using rapid tranquillisation to lightly sedate someone, reduce agitation or reduce aggression.

Cultural restrictive practices

A cultural restraint is when a person is prevented from doing something related to their culture. This can be a highly controversial practice and can easily contravene a person’s basic human rights, if not be discriminatory. Examples include not allowing someone to pray at a certain time or stopping someone from expressing their cultural views.

Environmental restrictive practices

An environmental restrictive practice is related to the physical environment the patient is in. Keeping a person in their bedroom at all times, locking their door, making someone go for time-out to calm down, isolating someone, preventing access to outside areas or using solitary confinement are all examples of environmental restraints.

Equipment/mechanical restrictive practices

A mechanical restraint is when equipment is used to stop someone from doing something. Mechanical interventions are usually used to restrict a person’s movement with the aim of controlling their behaviour. For example, using cuffs or belts when moving a patient from one mental health hospital to another.

Observational/surveillance restrictive practices

An observational restrictive practice is where a member of staff watches a patient at all times to keep track of what they’re doing, such as by using cameras in rooms, CCTV in hallways, sitting near them, using GPS trackers or keeping a patient in ‘eyesight’ or at ‘arm’s length’. However, observational restraints can prevent a person from having any privacy, so should be used with care. 

Psychological restrictive practices

A psychological restraint is any sort of communication – verbal or non-verbal – that puts pressure on a patient to do something or stop doing something. It might include routine shouting, telling off, making fun or ignoring someone in order to control their behaviour.

Physical restrictive practices

A physical restraint, also known as manual restraint, is when a patient is physically held in order to control their movement. Examples of physical restrictive practices are holding someone down in a chair, holding someone’s hands back or holding someone on the ground in order to subdue them or restrict their physical movements.

Social restrictive practices

Social restraints are used to prevent a patient from interacting with other service users, often because they’re seen as a danger to others or might be verbally abusive to them. Examples include preventing a patient from joining in with activities with other people and seclusion – keeping them away from others completely.

What are the Rules in Using Restrictive Practice?

Restrictive practices should only ever be used as a last resort and when all other options have been tried, as they can have a significant impact on a patient’s mental health and wellbeing and may even contravene their basic human rights. Restrictive practices must never be used to cause pain, suffering, humiliation or as a punishment.

Before using a restrictive practice or restraint, you must ensure:

1. All other options have been tried first.
2. Patients are asked for their views.
3. Patients’ rights are upheld.
4. There are clean plans for how the restrictive practice should be used.
5. Staff are trained in how to use restrictive practices correctly.

The Mental Health Units (Use of Force) Act 2018 is in place to ensure restrictive practices are not used unfairly. All patients have the right to be treated with dignity and respect, so the use of force as a restrictive practice must always be used proportionately, in accordance with the law and only ever as a last resort. The Act defines use of force as the physical, mechanical or chemical restraint of a patient, or the isolation of a patient (which includes seclusion and segregation).

Want to Learn More?

Increasing your understanding and awareness of mental health is vital for someone who works in health and social care. Take a look at our Mental Health Awareness Training to learn how you can initiate conversations about mental health, and where to go for additional support.

Furthermore, the Human Rights Act 1988 gives those living in the UK legal protection if any of their 16 basic human rights are contravened through the use of restrictive practices. You must keep a patient’s human rights in mind when determining whether a restrictive practice is necessary, as human rights can only be restricted in very specific circumstances.

Below are some additional rules in using restrictive practice that should be considered:

• If a restraint has to be used, it must be done in the best way possible for the patient.
• Only the minimal amount of restraint should be used.
• Where possible, find another way to solve the problem before using a restrictive practice or restraints.
• Consider the needs of the individual patient before using a restrictive practice, as they may need reasonable adjustments for their condition or disability.
• Ensure the details of any restrictive practices used are recorded in a patient’s personal care plan.

All patients deserve to be treated with dignity and respect, kept comfortable and have their rights upheld at all times. For this reason, restrictive practices can be highly controversial and should only be used as a last resort when all other efforts have been exhausted. If you work in health and social care, then it’s essential that you understand the rules for restrictive practices so you can truly look after the patients in your care.

Further Resources:

• Introduction to Safeguarding Adults
• Signs of Abuse in Adults 
• How to Deal with Resistance to Care
• Ensuring Human Dignity and Respect in Nursing: A Checklist
• What is the Mental Capacity Act?

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What is Resistance to Care?

Resistance to care is when somebody refuses healthcare assistance, whether that’s by pulling away from their nurse, trying to leave the room, refusing to take medicine or becoming annoyed or aggressive when you try to help them. It is a common behaviour amongst people in later life or those with dementia or Alzheimer’s, especially when it comes to personal care.

Resistance to care is most common in healthcare settings but it can also happen at home. For example, a wife with early stages of dementia may be resistant to the extra help offered by her husband, or an elderly grandfather may act aggressively when his son suggests he hires a cleaner to help take care of the house.

In a healthcare setting, resistance to care might take the form of refusing to take medicine, refusing to eat, pulling out equipment or tubes, wandering out of their ward or leaving the healthcare facility completely.

Why Might Someone Be Resistive to Care?

Resistance to care usually happens because the person doesn’t understand why they need help, is afraid of the new situation or feels uncomfortable, whether physically or psychologically.

Resistance to care is particularly common with hands-on, personal care tasks, such as washing and bathing, toilering, administering medicines and feeding – especially if the person feels undignified because of the situation.

Amongst people in later life, fear of losing their independence can be a key reason why they resist care. Everyone wants to be autonomous and no one wants to rely on someone to take care of them, especially if it involves personal care tasks. Accepting help from a healthcare professional can feel offensive to older people, as if they’re ‘giving in’ to ageing, harmful to their pride or, more often than not, an interference.

For those living with dementia, resistance to care is often due to a lack of understanding about what’s happening to them. The person may be aware that they’re struggling with simple tasks but unaware of how significantly it actually impacts their daily life. They may believe they can do more than they’re able to in reality and get irritated when people try to help. This is sometimes referred to as ‘lack of insight’, because the person with dementia cannot recognise they need assistance with tasks and will therefore refuse to accept any help given to them.

How to Deal with Resistance to Care

When someone is resisting care, it can sometimes feel like an uphill battle. You want to act in the best interests of the patient and do all you can to help them, yet they’re behaving combatively and it’s hard to maintain positivity. With the right techniques, however, you can deal with resistance to care in a compassionate and constructive way.

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Communication skills are essential to help any patient that is resisting care. Our Communication Skills in Health and Social Care Course will teach you about the different barriers to communication and how to overcome them, as well as how to respond to conflict appropriately and efficiently.

To handle resistance to care, try the following tips:

• Encourage the person to do as much as they can by themselves before you step in to help.
• Involve the person in the conversation about their care – avoid making decisions on their behalf if they have the capacity to choose themselves. Always strive for person-centred care.
• Put objects, activities, food and medicines within sight of the person, so they can do things themselves and see what’s going to happen next.
• Be consistent as much as possible, so the person knows what to expect and your care becomes just another part of their daily routine.
• For a person refusing to eat, tailor food and drink to the individual where possible, offering them choices you know they prefer and will be more likely to accept, such as adjusting portion sizes, chopping or not chopping foods up, putting gravy in a jug rather than on the plate, etc.
• Avoid arguing with the person if they’re refusing to eat, drink or take medicine. Instead, politely ask that they eat/drink/medicate, leave the item near to them, then walk away.
• Listen to complaints from the person and don’t be dismissive, even if their grumble seems very minor to you.
• If the person is resistant to washing or bathing, make the experience more appealing to them using aromas and bath products they like, improving cleanliness of the bathroom and using their favourite music.
• For a person refusing medication, be patient, positive and polite. Explain why the medication is necessary, politely remind them to take it, then leave the medicine within sight of the person whilst you get on with something else. Never force a person to take medication or threaten them with consequences.
• Always maintain the dignity of the person you’re providing personal care for by staying out of their personal space as much as possible, giving them privacy where you can, keeping them covered and allowing them to do as much of the care as they can on their own.
• Compliment and praise the person once they’ve allowed you to assist them with something – positive words go a long way in gaining your trust.

For the person in later life or the person with dementia, refusing help can be a matter of pride. They may be in denial that they can no longer live independently and be resistant to care for a long time before they admit that extra help is needed. No matter their situation, it’s essential that you always involve the person in the conversation and act in their best interests. Always be patient, compassionate and positive – even when this feels challenging.

Resistance to care can be hard work, for both the person resisting and the person trying to offer care. What’s important to recognise is that the person resisting care isn’t trying to be difficult or combative – they are simply reacting to their lack of understanding, discomfort or confusion about the situation. As a healthcare professional, you can help by understanding why a person may be resistive to care, then supporting them with compassion and kindness to overcome their barriers.

Further Resources

• Health and Social Care Courses
• Carers’ Breaks and Respite Care for Caregivers
• What is Delirium?
• What are Difficult Conversations in Health and Social Care?
• Restrictive Practices in Health and Social Care
• Promoting Independence in Health and Social Care

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In order to make guidance as clear as possible, and to continually strengthen safeguarding procedures, the government frequently revisits and updates safeguarding statutory guidance documents. As a result, it can be difficult to keep track of new requirements and how they impact your role. In this article, we will provide a summary of key legislation and statutory safeguarding guidance for schools.

Need Safeguarding Training?

Our range of Safeguarding Training Courses aim to provide you with the required knowledge to carry out your work whilst meeting safeguarding training requirements. Take a look at our course library where you’ll find everything from Designated Safeguarding Lead to Harmful Sexual Behaviour in Schools.

Key Legislation in Schools

Working Together to Safeguard Children, one of the key statutory guidance documents for schools (which we shall look at later), defines safeguarding and promoting the welfare of children as: 

• Providing help and support to meet the needs of children as soon as problems emerge.
• Protecting children from maltreatment, within and outside the home and online. 
• Preventing impairment of children’s mental and physical health or development. 
• Ensuring that children grow up in circumstances consistent with the provision of safe and effective care.
• Promoting the upbringing of children with their birth parents, or otherwise their family network wherever possible and where this is in the child’s best interest.
• Taking action to enable all children to have the best outcomes according to the outcomes set out in the Children’s Social Care National Framework.

There are several pieces of important legislation that contribute to the aims above, and influence policy and procedures regarding safeguarding children and young people. In the drop downs below, we give a brief summary of each law and its implications for safeguarding in schools.

Statutory Safeguarding Guidance

As well as Acts of law, the government issues further statutory guidance regarding safeguarding children and young people. These documents contain guidance which schools must follow, in addition to guidance that schools should follow. The expectation from the government is that schools would need justification for not following any good practice guidance marked ‘should’ but that it is a legal requirement to comply with anything marked ‘must’ (no justification would be acceptable for not complying with those). 

The key documents which you need to be aware of are:

• Working Together to Safeguard Children
• Keeping Children Safe in Education

These documents are updated at intervals, so it is crucial that you familiarise yourself with the current guidelines and keep up on top of any key changes. Doing so will enable you to make any necessary amends to your safeguarding policies or implement new procedures in your organisation, so you can continue to keep children safe from harm.

We will look at these key statutory documents below, providing you with a summary for each and signposting you to the most current versions.

Working Together to Safeguard Children (WTSC)

The Working Together to Safeguard Children statutory guidance document sets out the responsibilities that all organisations in England must fulfil to safeguard children and young people (which applies to anyone under the age of 18).

Last updated in 2023, it is aimed at everyone who comes into contact with children and sets out the concept that every agency, organisation and individual is responsible for working together to safeguard children.

The most recent update seeks to clarify the roles and responsibilities of those working with children and emphasises the need for strong multi-agency collaboration. It also highlights the importance of involving the whole family in the process of safeguarding, including the child themself.

Working Together to Safeguard Children is split into chapters which cover the following topics:

• Chapter One: A Shared Responsibility – this new chapter, introduced in 2023, includes expectations for multi-agency working and principles for building strong relationships with parents and carers.

• Chapter Two: Multi-Agency Safeguarding Arrangements – this chapter clarifies the roles and responsibilities of those who regularly work with children. 

• Chapter Three: Providing Help, Support and Protection – this chapter focuses on how early help can be delivered in education and childcare settings before examining how a broader range of organisations can contribute to the welfare of children. 

• Chapter Four: Organisational Responsibilities – this chapter emphasises the importance of effective information sharing across all organisations involved in safeguarding children.

• Chapter Five: Learning from Serious Child Safeguarding Incidents – this chapter examines what can be learnt from unfortunate cases so that safeguarding can be improved in the future.

• Chapter Six: Child Death Reviews – this chapter examines the responsibilities of those involved in child death reviews.

Keeping Children Safe in Education (KCSIE)

All education settings (including schools, colleges and state maintained nurseries) must follow the statutory guidance set out in Keeping Children Safe in Education.  Keeping Children Safe in Education clearly explains how to fulfil your safeguarding duties and promote the welfare of children. Like in Working Together, here ‘children’ refers to anyone under the age of 18.

This statutory document is split into sections. These may change slightly between amended versions (although the core subjects covered will remain the same). For the guidance which comes into effect from 1 September 2024, the sections are as follows:

• Part One: Safeguarding information for all staff.
• Part Two: The management of safeguarding.
• Part Three: Safer recruitment.
• Part Four: Safeguarding concerns or allegations made about staff, including supply teachers, volunteers or contractors.
• Part Five: Child-on-child sexual violence and sexual harrassment.
• Annex A: Safeguarding information for school and college staff.
• Annex B: Further information.
• Annex C: Role of the designated safeguarding lead.
• Annex D: Host families – homestay during exchange visits.
• Annex E: Statutory guidance – regulated activity (children) – supervision of activity with children which is regulated activity when unsupervised.
• Annex F: Table of substantive changes from previous version

Current guidance states that everyone who works directly with children read at least Part One of the guidance, and that those who do not work directly with children read either Part One or the condensed version found in Annex A of the guidance. It is the responsibility of the governing bodies or proprietors, along with the designated safeguarding lead to make sure that this happens.

Over recent years, this guidance has been updated and amended almost annually. You can keep up to date with key amendments by accessing our Hub article, Keeping Children Safe in Education: Key Changes.

Hopefully this summary has helped you to recognise where the key elements of our safeguarding and child protection policies and procedure have their basis. By remaining informed about legislation and statutory guidance as it evolves, you can make sure that your policies and practices are in line with requirements.

Further Resources:

• Keeping Children Safe in Education: Key Changes
• Guide to Safeguarding Children in Sport
• Health and Safety in Schools: Free Checklist
• How to Create an Effective Culture of Safeguarding in Schools
• Supporting Young Carers: A Guide for Teachers
• What is Contextual Safeguarding & Why is it Important?
• Creating a Safeguarding Policy – Example Template for Schools
• What is Safeguarding Training & Why is it so Important?
• How to Respond to Harmful Sexual Behaviour in Schools
• Safeguarding Flowchart: Procedure for Reporting Concerns
• Safeguarding Training Levels Explained: What’s the Difference?
• What is an Early Help Assessment?
• Safeguarding Scenarios and Answers for Education
• Advanced Safeguarding Children Training
• Single Central Record: KCSIE Guidance for Schools
• Safeguarding Children in Education Quiz
• Safeguarding Checklist for Schools

The post Safeguarding Children Legislation: Guidance for Schools appeared first on The Hub | High Speed Training.

In this article we will outline what the eight Caldicott Principles are, why they were introduced and how they apply within the workplace. We have also provided a free downloadable poster that can be printed and displayed within your setting, to act as a reminder and help to ensure everyone acts in accordance with these principles at all times.

What are the Caldicott Principles?

The Caldicott Principles are fundamentals that organisations should follow to protect any information that could identify a patient – such as their name and their health records. Organisations should always use the Principles as a way of determining whether sharing an individual’s information could identify them, and if it does, whether it is appropriate and relevant for it to be shared.

In 1997, Dame Fiona Caldicott – and the committee she chaired – produced a report regarding confidentiality and the transfer of identifiable patient information within the health service. From this, a set of standards known as the Caldicott Principles were formed. Originally beginning with six principles, subsequent reviews have since taken place, with a seventh and then an eighth principle being added in 2013 and 2020 respectively.

Why Were the Caldicott Principles Introduced?

Not so long ago, our personal information – including that relating to our health – was not protected from public access. This meant that not only could your personal information and health status become public knowledge, but that it could be used inappropriately. For example, those wishing to exert power or control over others and those who would use it as a means to socially discriminate and abuse others, were able to do so.

In the past, there were many stigmas associated with certain health conditions and treatments and the worry over this information becoming known within their community could be a huge source of concern and upset for many. As technology advanced, these concerns understandably became greater.

Therefore, the motivation behind the Caldicott report was the increasing concern about advancements in technology and its capability to distribute information about patients quickly and extensively. The basis of the review was to ensure that confidentiality was not being undermined.

The Caldicott Principles helped to set out what, when and how information could and should be shared – supporting an acceptable level of confidentiality without compromising the quality of care received. The formation of these standards helped to tackle the problems within the National Health Service (NHS) involving patient data and its accessibility, storage and use. 

As technological advances and the digitisation of data continues to evolve, keeping up-to-date with developments and the use of technology in health and social care is vital to help you to understand the various ways a patient or service user’s personal information can be used, stored and shared.

The 8 Caldicott Principles

Below is a summary of each of the eight Caldicott Principles as outlined by the National Data Guardian for Health and Social Care. You can find the information in full here. 

Principle 1: Justify the purpose(s) for using confidential information

Every proposed use or transfer of personally identifiable information, either within or from an organisation, should be clearly defined and scrutinised. Its continuing uses should be regularly reviewed by an appropriate guardian.

Principle 2: Use confidential information only when it is necessary

Identifiable information should not be used unless it’s essential for the specified purposes. The need for this information should be considered at each stage of the process.

Principle 3: Use the minimum necessary confidential information

Where the use of personally identifiable information is essential, each individual item should be considered and justified. This is so the minimum amount of data is shared and the likelihood of identifiability is minimal.

Principle 4: Access to confidential information should be on a strict need-to-know basis

Only those who need access to personal confidential data should have access to it. They should also only have access to the data items that they need.

Principle 5: Everyone with access to confidential information should be aware of their responsibilities

Action should be taken to ensure that those handling personally identifiable information are aware of their responsibilities and their obligation to respect patient and client confidentiality.

Principle 6: Comply with the law

Every use of personally identifiable data must be lawful. Organisations that handle confidential data must have someone responsible for ensuring that the organisation complies with legal requirements.

Principle 7: The duty to share information for individual care is as important as the duty to protect patient confidentiality

Health and social care professionals should have the confidence to share information in the best interests of their patients and within the framework set out by these principles. They should also be supported by the policies of their employers, regulators, and professional bodies.

Principle 8: Inform patients and service users about how their confidential information is used

Steps should be taken to ensure patients and service users understand how and why their confidential information is used. They should always be provided with accessible, relevant and appropriate information.

Looking for a Course?

Take a look at our catalogue of courses for those working in Health and Social Care. These include courses to help you further your knowledge of data handling, such as our Information Governance training course.

How to Apply the Caldicott Principles

The Caldicott Principles are something that all health organisations should follow and promote to staff to protect patient information. The seventh principle, however, can cause a lot of confusion in healthcare environments. Often, people are uncertain about when it’s acceptable to share information about someone and when it’s not. 

There are certain circumstances that override your duty of confidentiality. This is the aim of principle 7: to realise that sharing information can be as important as protecting confidentiality. It’s important that you can successfully balance the need for maintaining confidentiality with the need for keeping people safe.

You should share information about a patient when:

• They, or others, are, or might be, at risk of harm.
• They are at risk of posing harm to someone else.
• A crime could be prevented if the information is shared.
• A serious crime has been committed.
• A court order or other legal authority has requested the information.

Knowing both when and how to maintain confidentiality in health and social care is not only important to ensure you are upholding your legal responsibilities, but it also helps to build and support trust between yourself and those within your care. 

Always follow your organisation’s policies and procedures to make sure you are complying with confidentiality standards and the 8 Caldicott Principles within your day-to-day duties. This could mean that you do not provide the personal information of those within your care without certain identity checks, or it may mean that you do not repeat details of anyone’s personal life or events with those you don’t need to – including other colleagues.

Free 8 Caldicott Principles Poster

You can download our free poster at the link below. Why not display it within your setting to act as a reminder of the key principles of confidentiality.

Download Our Free Caldicott Principles Poster

The 8 Caldicott Principles provide a framework for all health settings to follow to protect identifiable patient information. If you work in a health setting, it’s important that you’re aware of these responsibilities and know what your duties are in relation to them.

Further Resources:

• Information Governance Training
• Duty of Care in Health and Social Care: Responsibilities & Examples
• How to Maintain Confidentiality in Health and Social Care
• What are the 6 Principles of the Care Act 2014?
• Compassion in Care: What Are the Six Cs?
• How to Deal with Resistance to Care
• Safeguarding Adults Quiz

The post What are the 8 Caldicott Principles in Health and Social Care? appeared first on The Hub | High Speed Training.

If you work in health and social care, it’s important that you understand your duty of confidentiality. You must abide by this duty and ensure that you respect your patients’ and clients’ legal right to privacy. In some rare cases, it may be necessary to override your duty of confidentiality, particularly if people are at risk of harm. Read on to find out more.

What is Confidentiality in Healthcare?

The definition of confidentiality in health and social care is keeping sensitive information private and respecting someone’s wishes. It means that professionals shouldn’t share personal details about someone with others, unless that person has said they can or it’s absolutely necessary. ‘Professionals’ in this context includes people like doctors, nurses, social workers, support workers, and employers.

In a health and social care setting, confidentiality means that the practitioner should keep a confidence between themselves and the patient, as part of good care practice. This means that the practitioner shouldn’t tell anyone what a patient has said and their details, other than those who need to know. This also includes not showing anyone – again, other than those who need to know – an individual’s personal notes or computer records.

Want to Learn More?

Our Information Governance Training is designed to help those who work in health & social care, giving you the tools to understand your obligations around data protection. See how else we might be able to support you with our full range of Safeguarding Courses.

Why is Confidentiality Important in Health and Social Care?

Confidentiality in health and social care is important for building relationships with service users. Keeping the necessary information private and respecting an individual’s wishes regarding sensitive information will help build trust. If a service user knows that their private information is going to be kept confidential, they will feel confident in sharing information to get the help and support they need.

It is also important to maintain confidentiality in health and social care as it is your legal duty. There are many different pieces of legislation and different policies in place to ensure that you maintain confidentiality.

How to Maintain Confidentiality in Healthcare

There are many ways that you can maintain confidentiality in health and social care, including:

• Reporting any breaches of confidentiality to the appropriate person.
• Remaining vigilant to whether the information you share is confidential.
• Following your organisation’s policies and procedures relating to confidentiality.
• Seeking guidance from the appropriate person when you are unsure about confidentiality.
• Communicating with service users to build trust.

How to Maintain Principles of Confidentiality in Childcare

It may also be the case that you frequently handle confidential information about children. The same principles of confidentiality apply in this situation: you should maintain confidentiality but override it if you think the child is at risk. Always be vigilant to recognising the signs or abuse and neglect and tell somebody if you think the child is at risk.

You should view confidentiality on a need to know basis, which means that you only share information when it’s necessary and with people who need to know. Relationships between professionals and children are built on trust, so it’s essential that you uphold a child’s confidentiality unless they are at risk. If you need to share a child’s information, ask for their consent unless there is a compelling reason not to do so. This is important for transparency, trust, and building a relationship.

Confidentiality Policy in Health and Social Care

There are many legislative requirements surrounding confidentiality in health and social care. If you work with patients and their records, then it’s important that you’re aware of patient confidentiality law and the following legislation.

The Common Law of Confidentiality

The principle of confidentiality is broadly taken from common law, which is why it’s called a common law duty of confidentiality. Confidentiality is important for encouraging people to come forward with issues and concerns.

However, there are certain offences and provisions where the duty of confidentiality is overridden. For example, if a girl has been a victim to Female Genital Mutilation (FGM), then this is a criminal offence and the appropriate authorities need to know. Additionally, if there is a serious safeguarding concern and somebody is at risk, then you have a duty to share this information to keep people safe.

The Human Rights Act 1998

The Human Rights Act gives every individual the right to respect for their private and family life. This includes having any personal information held in confidence. This right, however, is not absolute and can be overridden if necessary, such as for a safeguarding concern.

The Care Act 2014

This Act encourages caregivers to take a person-centred approach when safeguarding adults at risk. It also sets out a new way of thinking in relation to adult social care by explaining the importance of sharing information at early stages so that people stay safe.

The Health and Social Care (Safety and Quality) Act 2015

This Act sets out a number of provisions relating to the health and social care services in England. It covers the integration of information relating to users of health and social services. It also explains the sharing of information for individuals who use health and social care services.

The Data Protection Act 2018 and the GDPR

The Data Protection Act and the GDPR both have provisions that explain the way organisations, charities, and businesses must handle information. This includes care settings and provisions relating to clients, patients, and employees. Under Data Protection and the GDPR, personal information must be:

• Processed lawfully, fairly, and transparently.
• Collected for specified, explicit and legitimate purposes.
• Adequate, relevant, and limited to what’s necessary for the purposes of why it was collected.
• Accurate and up to date.
• Not be kept for longer than is necessary.
• Processed in a manner with appropriate security, including protection against accidental loss.

Examples of Confidentiality in Health and Social Care

Some examples of information that should be kept confidential include the following:

Relationship concerns – if a service user shares with you information about their relationships or family and asks you not to share the information, you have a duty to keep that information private. For example, if they have begun a romantic relationship with someone. However, if the relationship is a cause for concern, such as a child beginning a relationship with someone much older, you will have to break confidentiality.

Details of health – if a service user discusses their health or condition with you but doesn’t want other service users to know, you have a duty to keep that information confidential. For example, if a service user asks you about another service user’s health, you should inform them that you cannot discuss other service user’s conditions.

Personal details – information regarding a service user’s name, address, age, bank details and more, should be kept confidential. This information should only be shared with individuals that need to know, for example, the service user’s doctor.

When Can You Break Confidentiality in Health and Social Care?

There are many uncertainties surrounding confidentiality in health and social care. Common questions express concerns like ‘when shall I disclose confidential information?’ and ‘will I be breaching confidentiality in expressing my concerns?’.

To provide a simple answer: you may, in certain circumstances, override your duty of confidentiality to patients and clients if it’s done to protect their best interests or the interests of the public. This means you may override your duty if:

• You have information that suggests a patient or client is at risk of harm.
• You have information to suggest that a patient or client is posing a risk of harm to someone else.

In these instances, you should always report your concerns to your manager or supervisor. You should also help and contribute to any further actions that are taken to reduce the risk of harm.

However, sometimes things are not this simple and it can be easy to misread and misunderstand the signs. If you have any concerns about someone, or a confidentiality issue arises, you should always ask your manager or supervisor for advice.

Consider the following scenario, which explains why over-riding confidentiality is sometimes necessary.

Scenario

You are a care worker and you have gone to assist an elderly male at his home. You don’t usually assist this man, but his usual care worker has gone away for the week.

When you are helping him to get dressed, you notice several bruises on his back. When you enquire about these, he explains that his usual nurse attacked him last week and caused the bruises. He believes that he said something silly because the care worker started calling him names and then hitting him.

You are very concerned about this man’s safety when his normal care worker returns. He tells you that he doesn’t want you to tell anybody because the care worker is usually nice and it was just him making a silly comment that caused this to happen. He has become upset and he doesn’t want to get the care worker into trouble.

Conflict

There is a clear conflict in this situation. You believe that you should inform your manager immediately and report the other member of staff. However, the gentleman has begged you not to do this and has told you in confidence, so you don’t want to breach his confidentiality.

Resolution

In this situation, it is acceptable to override your duty of confidentiality. This is necessary to protect the man from further harm.

You should explain to him that you understand why he is upset and doesn’t want to speak out. However, explain that he has experienced a form of abuse that he has a right to be protected from and how you can help him.

Here, you are acting on behalf of the man’s best interests and within the Public Interest Disclosure Act. This means you can override your duty to protect his confidentiality and speak to your manager about what you have found.

You have a duty to protect patient confidentiality in health and social care. However, when a patient or client is at risk of harm or posing a risk to someone else, you may, in certain circumstances, override this duty if it’s done to protect their best interests or the interests of the public.

What to Read Next:

• How to Conduct Effective Handovers in Nursing and Patient Care
• What is Person-Centred Care and Why is it Important?
• Duty of Care in Health and Social Care: Responsibilities & Examples
• Champions in Healthcare: Role and Responsibilities
• Guidance on Complaints Procedures in Health and Social Care
• What are Difficult Conversations in Health and Social Care
• Managing Conflict in Health and Social Care: Guidance on Recognising and Handling Confrontations
• What is Professional Curiosity in Safeguarding?
• Promoting Effective Communication in Health and Social Care
• Using Technology in Health and Social Care
• Information Governance Online Training

The post How to Maintain Confidentiality in Health and Social Care appeared first on The Hub | High Speed Training.

This article will explain the meaning of gender inequalities, why the relationship between health and gender is so important, how gender affects healthcare, and what the women’s health strategy is. 

What are Gender Health Inequalities?

To begin answering this question, it is important to understand that there are differences between the terms sex and gender. The World Health Organisation (WHO) describes the term gender as referring to “socially constructed characteristics of women and men – such as norms, roles and relations of and between groups of women and men”. 

Sex on the other hand is described as being “mainly associated with physical and physiological features including chromosomes, gene expression, hormone level and function, and reproductive and sexual anatomy.” There are connections between both sex and gender and both can lead to inequalities in healthcare. 

Gender health inequality means having unequal access or opportunity to access  healthcare services and treatment due to your sex or gender, leading to poorer health outcomes. There are many other factors that can make someone more susceptible to inequalities in healthcare. For more  information on this topic, take a look at our article – What are inequalities in health and social care?

The WHO states that inequalities in healthcare disproportionately affect more women and girls than men and boys. Equality and diversity is a key part of being able to deliver high-quality, person-centred care and support to all throughout the sector. Yet health services within the UK lack vital knowledge and services to equally support the needs of both men and women. 

Want to Learn More?

For further insights into the values that under-pin patient care, check out our Equality and Diversity and Person-Centred Care training courses.

Understanding why such inequalities exist requires a much wider perspective on the gender inequalities that exist in many areas of life. The history of learning and power, particularly in medicine was very much focussed on men and heavily influenced by their opinions, perspectives and beliefs. 

This amongst many other factors has led to a lack of knowledge and understanding, not only around health concerns that affect only women, but also the different ways men and women can be affected by the same condition. Knowing such inequality exists makes it all the more important to understand the relationship between sex, gender and health. 

Why is the Relationship Between Gender and Health Important?

Understanding how an individual’s health can be affected based on their sex or gender is incredibly important in being able to ensure appropriate treatment, services and education are available to support them towards a positive outcome. Both of which can have a significant impact on a person’s risks and susceptibility and to illness.

For example, the relationship between gender and health may also interlink with social inequality. Many women and girls are given less autonomy over their bodies, have less decision making power and face greater discriminatory attitudes from healthcare providers, often making it harder for them to access the services and treatment they need, or receiving an accurate or timely diagnosis. 

Gender can also increase a person’s exposure to instances of domestic violence, emergency situations, work injuries, cigarette and alcohol intake and misuse, and certain risk taking behaviours. These are just a few examples, but understanding gender norms, socialisation and societal roles can create a better understanding of the links between gender and health.

The relationship between sex and health affects a person’s risk of disease, disease progression, the treatments given and the overall health outcome. For example, a particular enzyme found in men that binds to the SARS-COV2 virus (COVID-19) may be responsible for more severe outcomes and hospitalisations for men with the virus than women. 

What are the Quality of Care Differences Between Men and Women?

How a person views the quality of care that they have received can be subjective and will depend on their individual circumstances and perspective. However, quality of care should be based on core values, including equality and diversity, dignity, respect and compassion in care. 

Gender bias means having a preference of one gender over the other. It can be widespread in the health and social care sector and have a negative effect on health outcomes and systemic practices. 

Some examples include:

• Poor understanding of women’s health issues leading to delayed or misdiagnosis, such as overlooking potential causes of abdominal pain during a woman’s menstrual cycle, or not taking certain symptoms seriously if a woman is going through the menopause. You can learn about some of the common myths and facts around menopause here.
• Misdiagnosing a heart attack in a woman due to the idea that they mainly occur in men.
• Being less believing of certain symptoms or complaints of pain depending on a person’s gender or character. Such as assuming a ‘manly’ man is being stoic whereas a man who appears less ‘manly’ is being dramatic or emotional. 
• Treating a patient less favourably because they are gender diverse. Transgender individuals, for example, often experience high levels of mental health illness, due to the discrimination and stigma they face, including within healthcare settings.

How Does Gender Affect Health Care?

We have discussed how gender and sex can affect a persons’ health and the healthcare they are likely to receive, often coming down to reasons such as physiological and social factors. We have also looked at some examples of how gender bias impacts the quality of care an individual receives.  

When it comes to healthcare itself, gender and sex pose risks of vast inequality. Some reasons for this include:

• A lack of representation of women during clinical trials.
• A lack of knowledge on women’s health issues.
• Stigma associated with gender norms.
• Poor understanding of how conditions affect men and women differently.
• Gender bias on a systemic level and amongst healthcare professionals. 

A combination of factors are responsible for all inequalities in healthcare, including gender inequality and the issues are often complex and widespread.

6 Ways That Gender Affects Health

The reasons why certain diseases and conditions are more common in one particular sex or gender than the other can be complex. Factors such as genetics, behaviours and hormones can all play a part. Take, for example, six common illnesses that both men and women are affected by.

By understanding the complex relationship between sex, gender and health, professionals can paint a picture of which groups are most impacted by which illness. Some examples of conditions that are more common in one sex over the other include:

Men

• Heart disease.
• Parkinson’s disease.

Women:

• Alzheimer’s disease.
• Urinary tract issues.
• Osteoporosis. 
• Strokes.

What is the Women’s Health Strategy?

Women’s health is greatly impacted by inequalities in healthcare, from being underrepresented in research studies to a lack of understanding of certain female-specific issues. A lack of quality and availability of women’s health services leads to poorer outcomes for many, prompting the Government to take formal action.

In 2021, Nadine Dorries, the Minister for Patient Safety, Suicide Prevention and Mental Health, addressed the House of Commons, stating the Government would be creating a government-led national women’s health strategy for England. The first of its kind.  

The Government made a call for evidence and emphasised the need to understand the real experiences of the healthcare system from women of all ages and backgrounds. The experiences provided were intended to help focus understanding on six core themes, believed to connect the different areas of women’s health throughout all stages of life. These are:

• Placing women’s voices at the centre of their health and care.
• Improving the quality and accessibility of information and education on women’s health.
• Ensuring the health and care system understands and is responsive to women’s health and care needs across the life course.
• Maximising women’s health in the workplace.
• Ensuring that research, evidence and data support improvements in women’s health.
• Understanding and responding to the impacts of Covid-19 on women’s health.

The aim of this strategy is to tackle the deep-rooted issues within the healthcare system to improve the wellbeing and health outcomes of women and girls, breaking down the barriers faced to improve equal access and support for all. 

We all have the right to be treated equally, regardless of our sex or gender. By recognising the systemic issues within the health and social care sector and taking action to tackle the deep-rooted inequalities, the future may offer greater health equality for all.

Further Resources:

• What are Difficult Conversations in Health and Social Care?
• Safeguarding Training Courses
• How to Promote Empowerment in Health and Social Care
• Defining the Different Types of Discrimination in Health and Social Care

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