WCH25. Autonomy and Choice in Care Homes
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Autonomy and Choice in Care Homes (Wales) 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, furthermore, that they should be enabled to live with as much independence as is possible.
This policy sets out the values and principles underpinning this care service’s approach to the autonomy and independence of the people receiving care, which are in line with the principles and values of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 (particularly Regulation 15: Personal Plan, Regulation 21: Standards of Care and Support — Overarching Requirements, Regulation 25: Respect and Sensitivity, and Regulation 44: Premises — Accommodation-based Services Only).
Our Understanding of Autonomy
We understand autonomy to be the freedom to choose and the right to live an independent life. It understands autonomy to cover basic choices such as the following.
- Choice of how a person receiving care wishes to be addressed.
- Choice of being able to speak and communicate in Welsh as their first language.
- Choice of what to eat and drink.
- Choice of times of going to bed and getting up.
- Choice of use of time (ie of recreational activities).
- Choice in relation to the arrangement of their own environment.
- Choice of who to associate with.
- Freedom to manage their own finances.
- Freedom to control access to their accommodation.
{{org_field_name}} also recognises its legal and moral duty to protect and care for people receiving care, some of whom are vulnerable and may not always be capable of making choices that are in their, or any other person’s, best interests. It will, however, ensure that such the people receiving care are enabled to exercise as much.
How {{org_field_name}} Enables Its Residents to Have Control Over Their Own Lives
{{org_field_name}}’s approach to autonomy is to ensure that the people receiving 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. In particular, the home will do the following.
- {{org_field_name}} seeks to help prospective people to the service make a sound choice about whether they wish to enter the home by:
a. providing all necessary information about the home and its services
b. relating the information it provides to the individual’s assessed needs and expressed wishes, including making it available in the Wels language
c. allowing time for the person to take a considered decision
d. facilitating the involvement in the decision of the person’s friends, relatives or advisers where this is indicated
e. 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
f. 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
g. enable and help people receiving care 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. - {{org_field_name}} seeks to help the people using {{org_field_name}}s exercise their right to make informed choices about:
a. the care and support they receive from the staff
b. their preferred methods and means of communication, including where the person is Welsh speaking
c. the medical or other treatment they receive from visiting practitioners
d. their food, drink, diet and mealtimes
e. the visitors they receive (within any restrictions imposed because of the Covid-19 emergency)
f. the activities they engage in
g. the services they receive from other organisations
h. any other aspects of their lifestyles with which {{org_field_name}} can provide assistance
i. the risks sometimes associated with exercising choice. - In respect of care and support, {{org_field_name}} seeks to maximise choice by:
a. listening to, recording and as far as possible following individual’s preferences for the staff who provide their care and support
b. showing sensitivity to people’s feelings on the way in which services that might invade their privacy or dignity are provided
c. 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
d. enabling them to exercise their rights to see their personal information and records and respecting the confidentiality of their personal information
e. involving them as fully as possible if decisions must be taken in their best interests because of their incapacity to take those decisions. - In respect of medical and other treatment, {{org_field_name}} seeks to maximise choices by:
a. helping people to select practitioners with whom they feel comfortable
b. providing or accessing comprehensive information on health matters of concern to people receiving care
c. making available appropriate and individualised support to people who need help with medication or other health-related procedures which fall within {{org_field_name}}’s competence. - In respect of food, drink, diet and mealtimes, {{org_field_name}} will maximise choices by:
a. listening to, recording and as far as possible following individual preferences
b. arranging for as wide a range of choice as possible over when, how, with whom and where a person receiving care take meals
c. sensitively providing assistance with matters of food, drink and diet when such help is necessary or requested. - In respect of visitors, {{org_field_name}} seeks to maximise choices by:
a. listening to, recording and observing people’s views on the guests they wish and do not wish to receive
b. making available facilities for people to receive and entertain guests whenever they choose
c. ensuring that people’s guests are made welcome by staff and given every necessary assistance during their visits. - In respect of activities, {{org_field_name}} seeks to maximise choice by:
a. In respect of activities, {{org_field_name}} seeks to maximise choice by:
b. helping people to access as wide a range of activities as they would wish
c. ensuring as far as possible that necessary facilities, assistance and equipment are provided for social activities
d. where possible, assisting people to take part in activities outside the home
e. providing comprehensive information on all available social and community activities that might be of interest to people receiving care
f. personalising social activities to the needs and preferences of individuals. - In respect of the services received from other organisations, {{org_field_name}} seeks to maximise choices by:
a. making available information on educational, social, community and voluntary activities in which people might participate
b. supporting people who wish to participate in activities provided by other organisations
c. developing and retaining good relationships with as wide a range as possible of organisations that might offer activities of interest to people receiving care. - In respect of other aspects of lifestyles with which {{org_field_name}} might be able to provide assistance, {{org_field_name}} seeks to:
a. provide people receiving care with privacy for any sexual or intimate activities or relationships in which they wish to engage
b. help people to make the choices they would wish about their clothing and personal appearance
c. assist people receiving care in maintaining their political and civic rights
d. respect and accommodate individual’s personal idiosyncrasies and eccentricities
e. give relevant information to encourage people to change lifestyle behaviours that are a risk to health
f. inform people receiving care 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. - In respect of the risks sometimes associated with exercising choice, {{org_field_name}} seeks to:
a. provide people with as much relevant information as possible about the risks and benefits of the choices they make
b. carry out risk assessments with people receiving care where appropriate
c. propose alternative options to practices possibly carrying high risks
d. support people receiving care in taking responsible risks where there are commensurate benefits
e. 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.
a. Always be aware of and respect people’s rights to make their own decisions.
b. Avoid being overprotective or patronising to people receiving care.
c. Never attempt to bully or use force to coerce people receiving care to do anything that they do not wish to do.
d. Remember their duty to protect people receiving care and to ensure a safe environment for them to live in.
e. Always offer every person receiving care:
i. the choice of how they wish to be addressed
ii. the choice of when they want to go to bed and get up
iii. the choice of what they want to eat
iv. the choice of how they want to use their time
v. the choice of how they wish to maintain their environment
vi. the choice of who they wish to associate with
vii. the freedom to manage their own finances wherever they are able to do so
viii. the freedom to control access to their accommodation
ix. 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 people’s notes so that further action can be taken to protect people’s rights.
Training
All staff learn from induction onwards to recognise the rights of people receiving care and to understand the issues around autonomy and choice.
Induction training is linked to the All Wales Induction Framework for Health and Social Care.
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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