Autonomy and Choice in Care Homes (England) Policy

Policy Statement

We consider that every person receiving care has the right to freedom and choice over how they wish to live their lives and to live with as much independence as is possible.

This policy describes this care service’s approach to the autonomy and independence of the people who use its services and their rights to choose in line with its underpinning values and purpose and to comply with its registration requirements.

It is written in line with Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, particularly 9: Person-centred Care, 10: Dignity and Respect, and 11: Need for Consent.

Our Understanding of Autonomy and Choice

We understand autonomy to be the freedom to choose and the right to live an independent life such as over the following.

Choice of and control over:

how a person receiving care wishes to be addressed
times of their going to bed and getting up
what to eat and drink and when
use of time (ie of recreational activities)
the arranging of their personal space
who to associate with
the arranging of their personal affairs and finances
access to their accommodation and personal space
their care and support arrangements including medication.

{{org_field_name}} also recognises its legal and moral duty to protect and care for its users, some of whom are vulnerable and may not always be capable of making informed choices. It will, however, ensure that people are enabled to exercise as much choice as possible, eg having access to advocacy services that help them to express and exercise whatever choices they can make. These will include people who have been assessed as lacking mental capacity to take decisions and those who have met the tests of having been deprived of their liberty.

Our approach to autonomy and choice

People receiving our care have as much freedom of choice in their lives as is possible within a communal care environment, so long as that freedom does not expose them, or any other person, to unacceptable risk. It undertakes to carry out the following.

Preparations and planning before moving in

1. {{org_field_name}} seeks to help prospective person receiving care make a sound choice about whether they wish to enter the home by:

providing all necessary information about the home and its services
relating the information it provides to the individual’s assessed needs and expressed wishes
allowing time for the person to take a considered decision
facilitating the involvement in the decision of the person’s friends, relatives or advisers where this is indicated
making it possible for the person to visit the home, meet staff and other residents, and experience the home’s services on a trial basis
making it possible bring valued personal possessions with them if they move to {{org_field_name}}, the extent of which will be agreed prior to moving in
enable and help a person to handle their own financial affairs for as long as they wish to and as long as they are able to and have the capacity to do so.

Choices about care and treatment

2. {{org_field_name}} seeks to help the people receiving their care exercise their right to make informed choices about:

the care and support they receive from the staff
their preferred methods and means of communication
the medical or other treatment they receive from visiting practitioners
their food, drink, diet and mealtimes
visiting arrangements and visitors
the activities they engage in
the services they receive from other organisations
any other aspects of their lifestyles with which {{org_field_name}} can provide assistance
the risks sometimes associated with exercising choice.

Meeting needs

3. In respect of care and support, {{org_field_name}} seeks to maximise people’s choice by:

listening to, recording and as far as possible following individual’s preferences for the staff who provide their care and support
showing sensitivity to people’s feelings on the way in which services that might invade their privacy or dignity are provided
ensuring that all care and support is person-centred and appropriate to their social and cultural values, and that it relates appropriately to that individual’s needs and preferences
enabling them to exercise their rights to see their personal information and records and respecting the confidentiality of their personal information
involving them as fully as possible if decisions must be taken in their best interests because of their incapacity to take those decisions.

Healthcare needs

4. In respect of medical and other treatment, {{org_field_name}} seeks to maximise the choices of people receiving care by:

helping people to select practitioners with whom they feel comfortable
providing or accessing comprehensive information on health matters of concern to people receiving care
making available appropriate and individualised support to people receiving care who need help with medication or other health-related procedures which fall within {{org_field_name}}’s competence.

Nutritional needs

5. In respect of food, drink, diet and mealtimes, {{org_field_name}} will maximise people’s choices by:

listening to, recording and as far as possible following individuals’ preferences
arranging for as wide a range of choice as possible over when, how, with whom and where a person using services take meals
sensitively providing assistance with matters of food, drink and diet when such help is necessary or requested.

Social contacts and relationships

6. In respect of visitors, {{org_field_name}} seeks to maximise people’s choices by:

listening to, recording and observing the views of people receiving care on the guests they wish and do not wish to receive
making available facilities for people receiving care to receive and entertain guests whenever they choose
ensuring that people’s guests are made welcome by staff and given every necessary assistance during their visits.

Interests and activities

7. In respect of activities, {{org_field_name}} seeks to maximise people’s choice by:

arranging as varied and stimulating a social programme as possible
helping people to access as wide a range of activities as they would wish
ensuring as far as possible that necessary facilities, assistance and equipment are provided for people’s social activities
where possible, assisting people using services to take part in activities outside the home
providing comprehensive information on all available social and community activities that might be of interest to people receiving care
personalising social activities to the needs and preferences of individuals.

Community participation

8. In respect of the services received from other organisations, {{org_field_name}} seeks to maximise people’s choices by:

making available information on educational, social, community and voluntary activities in which people receiving care might participate
supporting people who wish to participate in activities provided by other organisations
developing and retaining good relationships with as wide a range as possible of organisations that might offer activities of interest to people receiving care.

Protecting human rights

9. In respect of other aspects of people’s lifestyles with which {{org_field_name}} might be able to provide assistance, {{org_field_name}} seeks to:

provide people using services with privacy for any sexual or intimate activities or relationships in which they wish to engage
help people using services to make the choices they would wish about their clothing and personal appearance
assist people in maintaining their political and civic rights
respect and accommodate individuals personal idiosyncrasies and eccentricities
give relevant information to encourage people to change lifestyle behaviours that are a risk to health
inform people using services and their relatives and friends of how to contact external agents such as advocates and voluntary representatives who will act in their interests should they wish.

Risk taking

10. In respect of the risks sometimes associated with exercising choice, {{org_field_name}} seeks to:

provide people with as much relevant information as possible about the risks and benefits of the choices they make
carry out risk assessments with people using services where appropriate
propose alternative options to practices possibly carrying high risks
support people using services in taking responsible risks where there are commensurate benefits
involve in consultations over the taking of risks any appropriate or nominated friend, relative, representative or advocate.

Expectations on Staff

Care service staff are expected to work to the following standards of conduct.

Always be aware of and respect people’s rights to make their own decisions.
Avoid being overprotective or patronising to people using services.
Never attempt to bully or use force to coerce people to do anything that they do not wish to do.
Remember their duty to protect people receiving care and to ensure a safe environment for them to live in.
Always offer every person receiving care:
the choice of how they wish to be addressed
the choice of when they want to go to bed and get up
the choice of what they want to eat
the choice of how they want to use their time
the choice of how they wish to maintain their environment
the choice of who they wish to associate with
the freedom to manage their own finances wherever they are able to do so
the freedom to control access to their accommodation
the freedom to self-administer their own medication (if assessed as safe to do so).

If for any reason a member of staff perceives the need to limit or restrict any of these choices and freedoms, the reasons should be discussed with {{org_field_name}} manager and a suitable entry written into the person receiving care’s notes so that further action can be taken to protect people’s rights.

Training

All staff receive training in person-centred care and support from their induction onwards, which includes recognition of a person receiving care’s rights to make choices, an understanding of the risks that might be involved and how best to manage any risks that are identified.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next Review Date: {{next_review_date}}

CH26. Autonomy and Choice in Care Homes