Person-centred practice is made up of a group of approaches, which are made to assist someone, to plan their life and the support that they want and require. Person-centred practice ensures that the individual concerned is at the heart of any decision making. This practice is more likely to be used when an individual has disabilities, or requires long term care and person-centred practice can help the service user to maintain and improve a level of independence, while receiving the best possible level of care.
Talerico et al (2003) identifies some essential areas of person-centred care: For carers to get involved in the service users life, so they are able to understand them better and get to know their personalities. Therefore they will be able to empathize with them more. When care is being established for the individual concerned, their needs, preferences and requirements must be addressed.
Seeing the service user as a biopsychosocial (sees individuals lead a biological, psychological and social dimension to their life) human being.
Encouraging the development of relationships that are trusting and caring. Ensuring freedom of choice for the individual concerned, while maintaining a reasonable risk taking approach. When you are assessing someone using a person-centred approach, you are taking into consideration the persons whole being, you are looking at their plan of care in a holistic way. The individual’s care package should take into account, their ethnicity, culture, religion, and most important of all their wishes and choices. Everyone has a right to make decisions about their own future and needs.
1.2 Critically review approaches to person-centred practice
In the past, the service and care that was provided to service users, was characterized by, prescription, diagnosis, and the assessment of needs and actions that were required to meet their needs. Nowadays the person-centred practice, means that there is a different kind of approach and a way of thinking about the elderly, or people with disabilities. It ensures that the service provider puts the service user in the centre of all planning.
This thinking just takes a small shift in the way that a person is assessed, by changing, what is important for a person, to what is important to a person. Person- centred approaches ensure that the service provider will make adjustments to the service that they provide for the service user, rather than expecting the service user to fit into an already existing service. Person-centred care must cover all areas of health and social care and is at the heart of good practice. There are certain values in obtaining a good practice that need to be met, such as: Seeing and respecting the individual as a person.
A critical review of approaches to person-centred care
The person at the centre of the plan, must be looked on as an individual who has ambitions, choices and strengths. They must be encouraged to make their own choices about how and when they would like to be supported. The service user must be able to make an informed choice about their care when they are given, the correct information and advice, and that they also have advocacy. This doesn’t always mean that they agree with the professionals that are assessing them, and this can cause some problems. Biographical life-story work
Life-story work is a biography of that person’s life and what they have experienced. There will be certain events in their life that are helpful to understand when they are going into a health and social care setting. It is very helpful to the person who is assessing an individual to know their background and past experiences, but they must be aware that they could be drudging up some bad memories, that could upset the person being assessed. It is essential for all care workers to read a service user’s life story, to get to know that person and see them as being unique.
Reablement is an approach to care that encourages the service user to be more independent and do things for themselves. This then gives them more confidence. Reablement concentrates more on getting back the person’s independence, instead of helping them integrate into a health and social care setting. It does give the individual more choice but at the cost of not developing new skills, just using existing ones.
Psychosocial approaches are used to take into account the whole social being of that individual and are based on psychosocial ideals. This approach can be quite useful when assessing older people or people with mental health issues, but they do not take into account the person’s whole life story and this approach can make it difficult to assess people who are intellectually disabled.
There is a report called `Developing social care, service users vision for adult support’, in that report the service users who contributed to it, felt that the social model informing policy, practice and procedures (Beresford,2005), should be the basis for social care. The social model has a lot of up to date legislation and policy underpinning it. A manager needs to be aware of all current legislations and policies, and how they affect the care setting. The Health foundation (2012) has reported that the `No decision about me, without me’, white paper, caused a great change in culture and practice in care settings. Law and policy have come together to make this happen.
The human rights act 1998 is created from the European Convention on Human Rights, which Great Britain signed in the 1950’s. The 1998 act includes articles from the convention, such as: Article 5 – The right to liberty and security.
Article 8 – The right to respect for private and family life. Article 9 – The right to freedom of thought, conscience and religion. Good practice in all care settings, should use the Human Rights Act 1998 as a foundation for their care, because it highlights the fact that the needs of the individual should be the most important value. This states that everyone has a right to receive quality of care. `The dignity, needs and wants of older people must be at the centre of their care, and Human Rights are the perfect vehicle to ensure this and to deliver quality care services’. (Age Concern, 2008).
The Equalities Act 2006 ensures that public authorities adhere to:
The act makes it unlawful to discriminate on the grounds of a person’s sexual orientation, religion and beliefs in the following areas:
The Equalities Act 2006 also created a single Commission for Equality and Human Rights (CEHR), which replaced the Equal Opportunities Commission (EOC), the Commission for Racial Equality (CRE) and the Disability Rights Commission (DRC). The (CEHR) are responsible for challenging unlawful discrimination and promoting understanding of equality and human rights issues. It also has a responsibility to ensure that everyone understands areas of discrimination, like, sexual orientation, religion, age or belief. It also has the scope to promote human rights and equality in other areas, which are not covered by specific legislation.
The Disability Discrimination Act, 1995 tries to ensure that disabled people don’t face discrimination and that they have the access to facilities and services, and that they have equal rights. The act states that service providers are to treat disabled people and give them the same opportunities as everyone else. It doesn’t matter if the services concerned are free or paid for, or if they are in the public or private sector.
One area of the NHS and Community Care Act, 1990, has required that local authorities are to establish a needs-led assessment in their care setting. They are also required to show that a service user’s preferences and choices are taken into account. This replaced the resource-led assessments, that meant individuals care was decided by what resources were available to them.
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