Unit 503
1.1
Equality is the right of individuals and different groups of people to have a similar social position and receive the same treatment by being treated fairly and equally and no less favourably, specific to their needs, including areas of race, gender, disability, religion or belief, sexual orientation and age.
Diversity is valuing the differences individuals or groups have and appreciating their individual characteristics, it recognises that we are all different and highlights the need to value each individuals input and needs. Inclusion refers to the aim of embracing everyone irrespective of race, gender, disability or any other need. Inclusion helps to remove barriers and eliminate discrimination. This applies to families, carers, friends, multi professionals, and colleagues, and as a manager I am responsible to ensure equality, diversity and inclusion is maintained at all times, as per Greenlight’s policy and legislation: models of practice we follow such as: person centered care, social model of disability and the diversity model. There are also several codes of practice which regulate equality, diversity and inclusion in my area of work: the equality act 2010, Human Rights Act 1998, Mental Capacity Act 2005, The Care Act 2014. Our approach also ensures we are compliant with Care Quality Commissions fundamental standards of quality and safety. I achieve this through respecting and acknowledging the needs of both customers and staff, offering support and help when required and altering my approach to suit, having an understanding of equality, diversity and inclusion allows me to engage both customers and staff without them feeling discriminated against on the grounds of: age, sex, disability, gender (including gender reassignment), marriage and civil partnership, pregnancy and maternity, race, religion or sexual orientation. At Greenlight we promote an open, inclusive culture where harassment, bullying ; discrimination cannot thrive. My position as manager requires me to be actively monitoring this and ensure people are aware and respecting these principles as they are central to our safeguarding procedures. In order to promote equality and diversity at Greenlight it is important that each staff member is aware and has an understanding of relevant legislation, principles and practices, which are achieved through training (Safeguarding vulnerable adults, Deprivation of Liberty safeguards and Equality and Diversity in Health and Social Care) without these it can be difficult to get staff to promote and support it. We also have an equal opportunities policy and procedure which staff read and sign to say they have understood the content and what is expected of them in their role.
1.2
There are many barriers to equality and inclusion in my own area of responsibility. These include:
Age- older staff members, this could cause issues if the manager is younger. Disability – environmental barriers if the customer or person was in a wheelchair, so would need to ensure that access/ramps were provided. Gender Reassignment. Discrimination, people not accepting it or judging others. Civil and Marriage Partnerships, some people might not agree with same sex marriages etc, so this could cause conflict. Pregnancy and Maternity -not being included or working with challenging behaviours, to ensure the person is always safe. Race -being judged for being from a different country, or having different coloured skin. Religion and Belief – having different beliefs such as a Christian or a Muslim. Trying your best to ensure the staff member is given time off for prayers.
Sex -Being discriminated against, based of gender. Sexual Orientation -being discriminated against for same sex partnerships. At Greenlight we have an inclusive environment where individuals are treated with equal respect as well as strictly adhering to the Equality Act 2010. The act ensures that everybody is treated equally regardless of their age, disability, gender, race, religion or belief and sexual orientation. For me to uphold this law in my position as manager I have to create a level playing field so everyone I work with and support have their needs catered for. As a company we are also governed by codes of practice which are outlined in our policies and procedures, these are regularly updated, inspected and followed to ensure inclusion and equality. As staff are recruited they are asked to read and sign these documents before commencing work in any of the homes, staff are also given extensive training, this includes exploration of the issues of equality and inclusion. Equality and diversity is also reflected in the recruitment and selection process so that the staff team reflects the diversity of the local population. At the home I work at, Littlecroft, it is part of my role to establish positive change to the lives of the three customers who are autistic and have associated learning difficulties who reside there and enable them to exercise their rights, make choices and gain full control over their lives. I always ensure I offer opportunities to everyone, and understand that everyone has the right to be different. Everyone has personal strengths, and an opinion, and I need to ensure we are non judgemental and allow opportunities for all staff and customers to flourish, and be accepted for who they are. I always ensure, when working with the customers, that we are person centred, and take into account the customers personal choices and preferences. Even if I don’t agree with the way a customer lives, I will always offer them the best opportunities to ensure they live their life the way they want to. If any barriers do arise when we are helping these customers achieve their life goals we act quickly to minimise or remove them by adapting the environment or equipment, and finding new resources in a person centered approach.
1.3
There are four key laws relating to equality and diversity which I must ensure we are adhering to within my role, these are: The Equality Act 2010 – this legislation provides protection against discrimination for people who possess one or more of the nine specific protected characteristics. These are age, disability, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex, gender reassignment and sexual orientation. The Human Rights Act 1998 – this legislation outlines the basic human rights and principles of equality. The ‘FREDA’ acronym helps you to remember what is covered by the Act: Fairness, Respect, Equality, Dignity and Autonomy. The Mental Capacity Act 2005 – notably the Deprivation of Liberty Safeguards (DoLS) which aim to help people who lack the capacity to maintain their independence, dignity and the right to freedom. The DoLS aid vulnerable individuals to maintain their right to dignity and equality. The Care Act 2014 – this legislation provides six key principles which should underpin all work with vulnerable adults. This includes ensuring that adults receive support that’s personal to them, chosen by them and has their consent. These act as a legal umbrella which underpin the the day to day work I do in the home, Greenlight has it’s policies and procedures within the home which are also regularly updated to promote equality, diversity and inclusion of which I must ensure the staff team are aware of and following to support our customers. I also monitor staff development and training making sure everyone is up to date and aware of these legislations, this is done through supervisions and appraisals as well as placing staff on training courses if required. Other areas of my job that incorporate the legislation and policies promoting equality, diversity and inclusion include: recruitment and selection, training and development, reviewing and adapting working practices, policies and procedures, care planning and environmental changes within the home.
2.1
It is part of my job description and role to ensure my staff team are all aware of and promote equality, diversity and inclusion when dealing with our customers, this is achieved through the following ways: Dignity and Respect – having a non judgemental attitude and understanding the different customers needs and their right to privacy. Communication – communicating at a level the customer understands, whether this is verbal, makaton, sign, braille, written, story boards or pecs. Feeling valued – ensuring each customer/staff member feels valued and utilising their strengths making them feel part of the team thus creating a positive working environment. Person centered care- tailoring services to meet needs of the customer. Removing barriers – change or alter physical barriers in the home or provide alternative methods in the community. Stereotypes, assumptions or bias – be aware of language used so you don’t offend people and don’t make assumptions or allow bias when making decisions. All of these areas are covered during training in a two week induction to the company and then annual training refreshers are required. As well as this staff attend regular supervision and appraisal meetings where they are made aware of their roles and responsibilities and are kept up to date with new developments in regard to equality and diversity amongst all the other training. I try to promote equality, diversity and inclusion through leading by example and following the guidelines laid out in Greenlight’s policies and procedures. It is difficult as some staff do have preconceived points of view and ideas leading them to be judgemental, I then have to remind them to respect each individual and their choices and leave their own beliefs to one side whilst at work and follow the policies, procedures and codes of practice they have read and signed up to as part of their employment.
2.2
It is extremely important that we follow the legal framework on equality, diversity and inclusion at Greenlight. It is my job to incorporate this into our everyday practice in the home I work at creating an inclusive positive environment without discrimination. We work towards our mission statement ‘Empowering people to achieve a lifestyle they are proud of’ we work in a person centered approach engaging customers, families and carers in shaping their support that works for them. This helps create a fair and equal service with a supporting culture where people are happy to challenge any type of discrimination that may arise. We work with multi agency teams to get the best outcomes for our customers and this helps raise the profile of equality and informed decisions whilst highlighting any change that may be necessary. We have a diverse staff team to support the customers, including different nationalities, gender, ages who all have the same job prospects, development and training. The training and open inclusive environment we have helps the team and myself challenge any discrimination or exclusion that maybe happening, it can be difficult to challenge especially if it is a colleague you work closely with or institutional. However, if the team and I feel confident about what is good practice it is easier to resolve, it can often be a lack of understanding (different culture) or may be just ignorance. It might be difficult to alter beliefs or points of view but is imperative that we challenge any discrimination that occurs. This can be done simply by explaining what has happened, mention the effect it has had and then present the individual with a better approach or model that does not discriminate. I have a duty of care with the customers and staff alike and it is my job to challenge any discrimination and promote inclusion, explaining the situation using fair appropriate language in a and positive manner makes it less likely for the incident to be repeated in the future.
2.3
We pass information onto staff about the effect of discrimination through regular training which staff attend and complete online so they are adequately equipped to promote equality, diversity and inclusion before working in the homes. I also conduct supervisions every six weeks, team meetings once a month and appraisals at three months, six months and then yearly intervals after joining the company. I will go through the policies and procedures with the team member and highlight how they should challenge any discrimination they suspect or witness as well as what they should do if they are the victim in any sort of discrimination. This helps to keep everyone’s training up to date and makes them aware of current procedures and practices as well as identifying any holes in knowledge and how to spot signs of discrimination. For example, it may cause mental and physical health implications such as stress, depression, anger, sleeplessness, poor hygiene, low self esteem, becoming withdrawn, sudden change in behaviour and absence from work. If the team are well trained, and have a good knowledge and understanding of inclusion, equality and diversity, and there is a level of transparency, and acknowledgement of feedback in an organisation, these are the best chances of reducing discrimination in the workplace. The teams will have an open culture, morale will be better, and staff will be more open to discussing concerns. Teams will be more aware if they see something that concerns them. By asking for feedback, during the induction, supervisions/appraisals, and feedback every six months from families and multi professionals, we are maintaining high standards, and will be made aware if concerns are expressed, and work hard to address those concerns, quickly and efficiently.
The impact of inclusion in the workplace can lead to a feeling of acceptance within the company and team you work alongside, this then creates stability through job satisfaction and commitment to work. Individuals will feel valued and respected creating better morale and working relationships and employees will work more effectively together by having an inclusive team. For our customers using a person centered approach, considering their needs and creating a service user plan to meet those needs inclusion can be attained. This is achieved through accessing services and informing them and supporting them to lead a life they want, developing their independence and self help skills to help them access and feel part of the local community. This approach helps promote health and wellbeing, reduces discrimination and inevitably increases inclusion.
The value of diversity is represented in our workforce and customer base and recognising that each person is unique and an individual. Our team consists of both males and females of all ages, race, nationalities and varying religions. I feel this diversity is of benefit to the customers as they can then gain different advice or points of view from a wider sample of the population who possess different skills sets. It also benefits the team when trying to solve issues as there is a greater depth of knowledge and different approaches all focused on trying to resolve the problem resulting in the best possible outcome. This not only benefits the company and team but will also help in supporting the customers at Greenlight.
2.4
I am responsible for supporting both customers and staff when it comes to challenging discrimination as well as dealing with any complaints/allegations they may have regarding this. By having regular supervision meetings with my staff team I encourage them to raise any issues that may be of concern to them coming from within the team. In our confidential meetings the staff team are able to express any concerns they are experiencing in the workplace. Once these issues are raised I will discuss with my line manager, and ensure all steps are taken, as per the policies and procedures. I also regularly check staff records to ensure that all the team are fully compliant with CQC standards in regards to their training, especially in this instance to equality and diversity, as well as safeguarding vulnerable adults. This ensures that the team are aware of what actions to take if they had concerns that a customer in our care was the victim of potential discrimination and/or exclusion, as well as proactive approaches in the workplace to promote equality and diversity.The systems and processes we have in place to use within at Green Light allows us to ensure the individual is included ensuring the process is fair, inclusive of the individuals needs, that our systems do not discriminate against culture, ability etc and promotes their rights and choices.
3.1
Greenlights policies are designed to reflect the roles and responsibilities of staff as well as the rights of the customers we support and care for to promote equality and inclusion, as well as outlining action plans to prevent discrimination and exclusion. ‘We are committed to eliminating discrimination and encouraging diversity amongst our workforce and customers. Our aim is that our workforce and customer base is truly representative of all sections of society and that each employee and customer feels respected, valued and able to give their best. ‘ If policies are well written and comprehensive following legislation, codes of practice and statutory frameworks it should create a culture where any forms of discrimination and exclusion are not present and if they do occur they should state how it will be dealt with. Also in place in a good system is the need for monitoring and reviewing to help maintain the promotion of equality and inclusion in the workplace and remove any form of discrimination that may unintentionally be there. New systems put into place can sometimes be ignored by long serving members of staff who have always worked in one particular way and do not like change this can create institutional discrimination and exclusion if they are not willing to change the way they work and adopt new methods put in place.
3.2
Within my own area of responsibility, it is important that the systems and processes are effective in promoting equality, diversity and inclusion. At Greenlight policies such as: equal opportunities policy, compliments, concerns and complaints policy, policy feedback and review, whistle blowing policy and procedures, harassment and or bullying policy are in place to ensure we follow good practice and legislation, which in turn promotes equality for both customers and staff, this helps us achieve a good open, transparent culture where each individual is provided with the opportunity to thrive free from prejudice and discrimination. We have systems in place for effective monitoring, reviewing and reporting on equality, diversity and inclusion. Monitoring includes, providing service users with monthly questionnaires they complete with their key workers and families have an opportunity to give feedback via questionnaires after visits to complete, whilst staff have opportunities in supervisions and appraisals to address any concerns. There is also a complaints procedure in place for staff, customers and families, it is my responsibility to ensure everyone is aware of the procedure, this enables them to have a voice and know their opinions are important and that they can report any discrimination or inequalities they suspect or witness. All complaints are logged on the Greenlight computer system, I can then flag these with my line manager so each issue can be dealt with in the most appropriate manner.
3.3
In my short time as manager I have found that these systems appear to work well at Greenlight, some companies can unwittingly discriminate through institutional discrimination, when long serving staff don’t like change ‘this is the way we have always done it’, this is where Greenlight are excellent with their feedback forms, questionnaires, supervisions, appraisals etc and are always looking to improve and add to or rewrite policies and procedures if necessary. This constant evaluation of practices provides us to gain the views of staff, customers and families, which in turn helps us reflect as a company on the service we provide, allowing us to celebrate our strengths and put plans in place for any areas which require attention. If I felt any areas did need addressing due to gaps or shortfalls I would draw up an action plan with detailed recommendations and proposed changes or policy reforms. It would also include how improvements would be made and a timescale for any proposed changes needed.. All team members would be made aware of their own roles and responsibilities regarding plan of action.
4.1
Working in health and social care I am faced with ethical dilemmas on a frequent basis especially in my chosen field of autism. It is important that I have a good understanding of the legal ramifications around these and how myself and my team should conduct themselves appropriately in a professional manner and not let our own morals or opinions cloud our judgement when helping the customers we support. Working with vulnerable people we have a duty of care to protect the individual rights, having a person centered approach at all times enables good practice and helps us achieve this. Areas of support I have worked on to balance rights and duty of care include: safeguarding customers that present challenging behaviour and can be aggressive causing harm to themselves or others, it may be necessary to restrain them to prevent them or others coming to significant harm, ensuring their safety. The customer may not wish to be restrained but it is in their best interests and we have company policies on these methods and physical intervention training to carry them out safely. This has happened in the customers own home environment when he has tried to assault a staff member and whilst out in the community to prevent him running out onto roads. We need to act quickly and effectively in these situations to obtain the best possible outcome. Another issue that arises a lot with one particular customer is the wishes he has to be ‘as fat as a house’ as he puts it, he would like access to as much food as possible to achieve this. However it is our duty of care to help him live a healthy lifestyle and have a life he can be proud of, when he consumes lots of food he quickly becomes anxious through the guilt of eating too much which in turn effects his emotional well being and prevents him from accessing the community. This customer does have some restrictions (DoLs) around his access to food after assessing his capacity and decision making inline with the MCA 2005 but it still remains a dilemma around meal times regarding portion size and so on and his right to make an unwise choice. It was necessary to follow the MCA to establish capacity and promote safeguarding within a legal framework to ensure the best interest of the customer were being met alongside our duty of care. Confidentiality and disclosure also form part of my responsibility when sharing information, we are governed by the Data Protection Act in regards to this and if required can breach confidentiality if a customer is at risk from significant harm or abuse. This is part of my duty of care towards the customer I support even if they wish for me not to disclose any information they might tell me even it they would like it to remain confidential. In my role as manager I also have to work with my staff team to make sure they are not putting their own values and beliefs into the customers lives and disregarding their choices thinking that they know what is best for them. We had one member of staff who would ignore the customers choice of evening meal as per there menu plan as she thought it was unhealthy and would make a completely different meal for the customer and herself, once this was brought to my attention it was addressed quickly by myself and the staff member was reminded of their duty of care and responsibilities as well as having to carry out extra training. Another area which crops up frequently challenging my values and beliefs is when customers refuse to take medication, I am aware of the medical needs for these and the benefits the customers receives from taking them as prescribed by the doctor. However the customers have a right to refuse medication, all I can do in this situation is present the customer with pros and cons of not taking them and record the information according to our medication policy and notify the doctor.
4.2
Informed choice is where the customer is presented with all the information required to make a decision, the information provided should be factual, accurate, accessible in a form they understand and available when required. The decision must be voluntary and the customer must have the capacity for choice, which rests on three elements: possession of a set of values and goals, the ability to understand information and communicate decisions, and the ability to reason and deliberate. It is about empowering and involving the customer to take control of their life when and where possible looking at their needs and preferences.
4.3
Under the Mental Health Act 2005, we must always assume that someone has the capacity to make decisions over their own life unless they are unable to understand the relevant information, retain the information, weigh up the information and make and informed choice. Informed choice might have to be looked into by a best interest meeting if it is felt that a customer is unable to make their own decisions or repeatedly makes unwise decisions which are detrimental to their well being. At this stage a mental capacity assessment would be implemented by a competent person and followed up with a best interest meeting composed of a multidisciplinary team to conclude a decision on behalf of the customer. Over time capacity may change, for example this could occur through a change in medication, therefore we need to regularly review, update and amend if necessary as well as having regular meetings to ensure we are working in the customers best interests.
4.4
One of the customers that resides at Littlecroft enjoys surfing, before he moved in concerns were raised over the associated risks that come with surfing. After meeting with the customer and his mum it was apparent this was a big part of his life and if he could not continue surfing it could be detrimental to his emotional well being as participating in the sport helped reduce his anxieties. The need to surf on a lifeguard patrolled beach was raised but would be problematic over winter when there is no lifeguard cover. There were also concerns from some team members who can not swim, surf or would feel comfortable in the water with the customer. The Greenlights risk management policies were addressed and they stated that management and support staff would assess risks, manage them and ensure the pro’s outweighed the risks. A person centered plan was completed prior to the customer joining us and it stipulated his desire to keep up with and improve on his surfing. The customer was deemed to have full mental capacity as he was able to make an informed decision after understanding the risks, weighing up the information and retaining the information for a period of time. It was agreed that this customer could continue surfing, however we have rigorous risk assessments in place, the customer also undertook a lifeguard and first aid course.The customer and his mum also agreed to sign a disclaimer, as although we could risk assess, in this instance we couldn’t be liable if there were to be a catastrophic accident such as drowning. Our risk assessment highlighted the risks of surfing unsupported, we could manage certain risks within our support and the abilities of the customer enables him to engage in an activity that he was passionate about. This also demonstrates that as a company, we need to undertake ‘risks’ in life in order that our customers are able to fulfil meaningful lives. Risks need to be established at times in order for the customer to progress. As our mission statement stipulates, the intention should be to enable our customers to lead full, varied lives without unnecessary restrictions but acknowledging we have a duty of care to minimise risks within our own abilities.