Principle 1

Summary

Sometimes you may come across situations or behaviours in a care and support setting which are dangerous, demeaning, upsetting or inappropriate. In such circumstances, to maintain your personal and professional integrity, you need to have a clear understanding of what you can do to challenge others and how to rectify the situation.

Good practice scenario

Situation

A young man with a profound learning disability living at home with his family.

His parents made many decisions for him including what he ate for breakfast; however it was noticed that he didn’t like some of the foods he was given for breakfast. He could not verbally communicate this but he would screw up his nose and when certain foods were given he would demonstrate challenging behaviours. Discussions with his family were initially difficult as they felt they were more in tune with his likes and dislikes than the care worker. However his preferences and wishes weren’t always being taken into consideration, so it was necessary to try to challenge the family in a careful and professional way. Doing this resulted in the issue being successfully resolved and made a real improvement to the man’s quality of life. Actions taken:

  • Recorded the man’s behaviours and reactions when eating breakfast and the changes that happened when he was not enjoying some foods.

  • Used this evidence to discuss his preferences with his family.

  • The family, having seen the evidence, appreciated that a change was needed and were happy to support finding new foods that were acceptable to him.

  • Documented his wishes, preferences and choices as part of his person-centred care plan.

  • Ensured future changes in preferences would be noted and implemented.

Dilemma

You are working with a colleague supporting an individual to go to bed and they require hoisting from their wheelchair to their bed. Your colleague is cutting corners, not talking the individual through the process and is rushing. The individual is showing signs of distress. You feel that this is a potentially dangerous situation with the individual being placed at risk, but your colleague insists that it is standard practice.

  • Would you whistle blow and to whom? Or challenge your colleague directly?

  • Is there anything that will make it easier for you to challenge your colleague and how would you go about doing this?

  • Is there a whistle blowing policy or another policy to support you in your organisation?

  • Do you feel that your sense of loyalty to your colleague has any place?

“You hear of all these awful things, like Winterbourne, where people tried to whistle blow but were ignored. But I think I still would do it, if I saw someone being treated badly. You owe it to them as a fellow human being, I think”
Carer

“If you see something you don’t like, you have to think carefully. Is it just that I’d do that differently, or is it a fundamental problem? Did that action show disrespect to her or ignore her wishes? If so, you have to act, otherwise you lose some of your own self-respect”
Care and support worker