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Autonomy and Choice in Supported Living (England) Policy

Policy Statement

We consider that every person receiving our care and support 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 service provider’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 Regulation 9: Person-centred Care, Regulation 10: Dignity and Respect and Regulation 11: Need for Consent. It also reflects an individual’s tenancy rights under housing law as set out in their tenancy agreement.

Our Understanding of Autonomy and Choice

We understand autonomy to be the freedom to choose and the right to live an independent life such and have choice 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 in their accommodation
• 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 as tenants and who receive our care and support have as much freedom of choice in their lives as is possible 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 to take up a tenancy

1. {{org_field_name}} seeks to help prospective tenants and users of our care and support make a sound choice about whether they wish to enter the service by:

• providing all necessary information about the care and support on offer
• relating the information it provides to the individual’s assessed needs and expressed wishes for both their accommodation and the care and support that we also provide
• allowing time for the person to take a considered decision about how and from whom to receive their care and support
• allowing time for the person to take a considered decision
• making it possible for the person to meet staff and other people using the service, inspect their accommodation and have a trial period if required
• making it possible to bring valued personal possessions with them if they move into the accommodation, the extent of which will be agreed prior to moving in
• enabling and helping 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}} will help the people receiving its care and support to make informed choices about:

1. the care and support they receive from the staff
2. their preferred methods and means of communication
3. the medical or other treatment they receive from health services
4. their food, drink, diet and mealtimes if part of the agreed service
5. the visitors they receive
6. the activities they engage in
7. the services they receive from other organisations
8. any other aspects of their lifestyles with which {{org_field_name}} can provide assistance
9. the risks sometimes associated with exercising choice.

Meeting needs

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

1. listening to, recording and as far as possible following individual’s preferences for the staff who provide their care and support
2. showing sensitivity to people’s feelings on the way in which services that might invade their privacy or dignity are provided
3. 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
4. enabling them to exercise their rights to see their personal information and records and respecting the confidentiality of their personal information
5. 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}} will maximise the choices of people receiving care by:

1. helping people to select practitioners with whom they feel comfortable
2. providing or accessing comprehensive information on health matters of concern to people receiving care
3. 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.
4. helping to resolve any evident inequalities that people are experiencing in their healthcare.

Nutritional needs

5. In respect of food, drink, diet and mealtimes, which the service provides or supports the person receiving care to obtain, {{org_field_name}} will maximise people’s choices by:

1. listening to, recording and as far as possible following individuals’ preferences
2. arranging for as wide a range of choice as possible over when, how, with whom and where a person using services take meals
3. 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 and social contacts, {{org_field_name}} seeks to maximise people’s choices by:

1. listening to, recording and observing the views of people receiving care on the people with whom they wish and do not wish to have contact or a relationship
2. making available facilities for people receiving care to receive and entertain guests as they choose in their accommodation
3. 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:

1. enabling as varied and stimulating a social programme as the person wants and needs
2. helping people to access as wide a range of activities as they would wish
3. ensuring as far as possible that the necessary facilities, assistance and equipment are provided for people’s social activities
4. supporting people using services to take part in community activities
5. providing comprehensive information on all available social and community activities that might be of interest to people receiving care
6. 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:

1. making available information on educational, social, community and voluntary activities in which people receiving care might participate
2. supporting people who wish to participate in activities provided by other organisations
3. 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:

1. provide people using services with privacy for any sexual or intimate activities or relationships in which they wish to engage
2. help people using services to make the choices they would wish about their clothing and personal appearance
3. assist people in maintaining their political and civic rights
4. respect and accommodate individuals personal idiosyncrasies and eccentricities
5. give relevant information to encourage people to change lifestyle behaviours that are a risk to health
6. 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.
7. protect their rights through the provider’s “fair tenancy” agreements.

Risk taking

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

1. provide people with as much relevant information as possible about the risks and benefits of the choices they make
2. carry out risk assessments with people using services where appropriate
3. propose alternative options to practices possibly carrying high risks
4. support people using services in taking responsible risks where there are commensurate benefits
5. 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.

1. Always be aware of and respect people’s rights to make their own decisions.
2. Avoid being overprotective or patronising to people using services.
3. Never attempt to bully or use force to coerce people to do anything that they do not wish to do.
4. Remember their duty to protect people receiving care and to ensure a safe environment for them to be part of.
5. Always offer every person receiving care:
   a. the choice of how they wish to be addressed
   b. the choice of when they want to go to bed and get up
   c. the choice of what they want to eat
   d. the choice of how they want to use their time
   e. the choice of how they wish to maintain their accommodation and environment
   f. the choice of who they wish to associate with
   g. the freedom to manage their own finances wherever they are able to do so
   h. the freedom to control access to their accommodation
   i. 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.

If people seem unable to exercise choice because of mental incapacity all decision taking will follow Mental Capacity Act processes and procedures.

Training

All care and support 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.

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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}}

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