In this Care Certificate Guide Standard 7
After reading this Care Certificate Standard 7 – Privacy and Dignity, you should be able to:
- Understand the principles that underpin privacy and dignity in care.
- Maintain the privacy and dignity of the individual(s) in your care.
- Support an individual’s right to make choices.
- Support individuals in making choices about their care.
- Understand how to support active participation.
- Support the individual in active participation in their own care.
The Care Certificate Standards detail what you must achieve and be assessed against to meet these learning outcomes.
If you have any concerns or queries, you should discuss these with your employer and/or assessor.
What Privacy and Dignity Mean and Why They Are Important
There are two values that are extremely important when providing care and support. These are privacy and dignity.
Privacy means:
- Giving an individual space and time where and when they need it.
- Recognising when they wish and need to be alone (or with family and friends).
- Treating their personal information confidentially.
Dignity means:
- Focusing on the value of every unique individual.
- Respecting their opinions, preferences, choices and decisions whether you agree with them or not.
- Not assuming how they want to be treated.
- Working with care and compassion.
- Communicating directly with them whenever possible.
Person-centred Values
Privacy and dignity are person-centred values, and this is covered in Care Certificate Standard 5.
Remember that everything you do must be in the interests of the individual receiving care or support. This means working in a person-centred way and always protecting an individual’s privacy and dignity.
Promoting Safeguarding and Wellbeing
The safeguarding and wellbeing of individuals who you care for and support, are of vital importance.
As much as possible, you should:
- Get to know each individual, i.e. find out about their background, ideas, likes and dislikes.
- Always put them at the centre of their care by providing personalised care and support.
- Help them to be as independent as possible.
- Respect their privacy and dignity.
Working like this will reduce the risk of individuals being treated in ways that are harmful or degrading.
Privacy of Information
Part of providing good quality care and support includes:
- Building trust and confidence.
- Having the best interests of the individual in mind.
You must be extremely careful not to discuss the individual’s personal information where you might be overheard, or to speak too loudly.
Personal information includes an individual’s:
- Health conditions.
- Sexual orientation.
- Personal history.
- Social circumstances.
You may have situations where the individual trusts you to keep other private information they discuss with you, to yourself.
By upholding confidentiality, it will help you build trust with the individual. However, there may be circumstances where you have to pass on the information for health and social care reasons.
Confidentiality
Individuals receiving care and support have important rights when it comes to the confidentiality of their personal information.
To uphold confidentiality, you must:
- Only share information on a need-to-know basis, e.g. with other workers involved in the individual’s care.
- Not share information with anyone else without the individual’s permission, including their family or friends. For example, the individual may not want their family or friends to know about their health or unhappiness.
As you have learned, confidentiality is a vital part of building trust and confidence.
Privacy Dilemmas
There may be instances where the individual does not want to share information which you believe should be passed to other workers to provide the care and support they need.
In these types of situations, it is vital to explain this to the individual and give your reasons.
Try to agree with the individual about the level of information they will allow you to pass onto others. If you believe that this is still not in the individual’s best interests, you should speak to your manager about your dilemma.
Your manager can help you determine whether you should inform the individual of the need to pass the information on in the best interests of their care and support.
Understanding What Privacy and Dignity Are in Care and Support
Individuals who you are caring for and supporting must always feel safe and comfortable. To help them feel this way, you should:
- Find out how the individual wants to be treated in different situations by speaking with them or looking through their care plan.
- Find out the extent to which the individual wants their family members, friends or carer to be involved or updated regarding their care and support. The individual may wish to have complete responsibility for:
Passing on the information.
Deciding on the extent to which they want them involved in their personal care or life. - Respect and support their choices, which will occasionally require you to sensitively challenge the assumptions that others have made.
Protecting and Respecting Privacy and Dignity
It is vital to find out from the individual what is comfortable for them, as each different person will have different views regarding privacy and personal space. Also, you must always work in ways that respect the individual’s dignity.
Issues regarding privacy and dignity will vary in each workplace. You should discuss the specific issues with your manager or other workers to ensure that you understand what they are.
Compromising Privacy and Dignity
You must be extremely careful not to unintentionally compromise an individual’s privacy and dignity whilst providing care and support.
Some examples of situations where this could occur are as follows:
- Touching the individual when helping them wash, dress or apply body cream.
- Entering the room the individual is in, and they are unaware of your presence.
- Discussing an individual’s personal information where unauthorised people can overhear.
- Arranging the individual’s clothing or hospital gown.
- Supporting the individual to go to the toilet.
Maintaining Privacy and Dignity
You have looked at some examples of situations where an individual’s privacy and dignity could be compromised.
To reduce the risk of this happening, you should always work in ways that protect and respect their privacy and dignity, for example:
- Do not make them wait to use the toilet or be left for too long before you return.
- Always ask for their consent before touching them in any way and keep them informed throughout the process.
- Make your presence known and gain their consent before entering the particular space, bedside, cubicle, room or home they are in.
- Make sure you speak quietly and away from others who could overhear when discussing their personal information.
- Make sure curtains, screens or doors are properly closed before supporting them to wash, dress, including when applying any all-over body cream.
- Arrange clothing or hospital gowns in a dignified manner.
Promoting Dignity by Involving Individuals in Decision-Making
Choice and control are key defining aspects of dignity.
To promote the dignity of all individuals, they should be fully involved in:
- Any decision that affects their care, including personal day-to-day decisions, e.g. what to eat, what to wear and what time to go to bed.
- Wider decisions regarding their care or support, e.g. financial planning.
Informed Choices
Individuals can only make decisions if they have all of the necessary information.
To support them in decision-making, you should make them aware of and explain the following:
- All of the available options.
- The risks associated with these options.
- The possible implications of making these choices.
Having an awareness of these factors can help the individual make the choices that are right for them. This is known as making informed choices.
Difficulties in Decision-making
There may be times when an individual has all of the information to make an informed choice, but they find it difficult to decide.
Every effort should be made to support an individual to understand the information and to communicate their choices.
There are many ways of helping an individual and supporting them to make an informed choice.
You could:
- Explain the information.
- Find people who can share their experiences.
- Ask for help from specialist workers.
- Involve other people they trust, e.g. family or friends.
- Use additional options, such as an advocate.
An advocate can help the individual understand and consider their options and the risks to assist them in making a decision.
Mental Capacity
Occasionally, an individual may be incapable of understanding and retaining the information required to make decisions or communicate their choices. In these cases, they may be assessed as lacking the mental capacity to make decisions.
The individual may be capable of making day-to-day decisions, for example:
- What they want to wear.
- What they want to eat.
- When they want to get up.
- The activities they want to be involved in.
However, they may not have the capacity to make complex decisions, for example:
- Financial matters.
- Medical issues.
If you are ever unsure about the individual’s capacity to make decisions, you should seek additional advice or guidance from your manager or supervisor.
If, after assessment, it is concluded that the individual lacks the capacity to make decisions, any made on their behalf must have their best interests in mind.
The Importance of Risk Assessment and Enablement
Risk assessments must be carried out when looking at options regarding an individual’s care and support, and when helping them make decisions.
Risk Assessments:
- Are a legal requirement under the Management of Health and Safety at Work Regulations 1999, and other specific health and safety laws.
- Provide clear guidance on the measures needed to prevent danger, harm and accidents, and therefore keep people safe.
- Are a key part of an individual’s care, support, rehabilitation or treatment plan. This will contain information on their daily care and support, e.g. personal hygiene or mobility, and the best ways of protecting them and others from harm.
- Contain information on the possible hazards associated with the care and support provided, and the steps required to control any risks.
Five Steps to Risk Assessment
The Health and Safety Executive (HSE) suggests the following five steps to risk assessments:
- Identify the hazards.
- Decide who might be harmed and how.
- Evaluate the risks and decide on precautions.
- Record your findings and implement them.
- Review your assessment and update if necessary.
These five steps must be followed before introducing a new activity. The risk assessment process can also be used to support individuals to make their own decisions.
Risk Enablement
The choices an individual makes will be shaped by factors such as their:
- Background.
- Values.
- Culture.
- Religion.
- Past experiences.
As a health and social care worker, you can give your view on the individual’s choices.
However, once an individual understands the information available and is fully aware of the risks, they have the right to:
- Weigh up and take risks.
- Make choices which they believe will make their life enjoyable and worthwhile.
Supporting an individual to identify and assess their own risks, and then enabling them to take the risks they choose, is known as risk enablement.
Complaints
Involving the individual in the planning of their care and support, as much as possible, is what the person-centred approach in health and social care tries to achieve.
Despite using a person-centred approach, there may be instances where the individual is dissatisfied with:
- the decisions that have been made for them; or
- the choices that have been offered.
If you do not have the authority to change this, you should:
- Inform the individual about their right to make a complaint.
- Support them to follow the complaints procedure.
Active Participation and Self-care
Active participation is a way of working that supports individuals and gives them as much control of their life as possible.
It also helps individuals to build their identity and self-esteem by taking control of their care and support.
As a health and social care worker, you should listen to the individual and take the following into account at all times:
Keep equality and diversity in mind. Individuals should be given an equal opportunity of:
- Achieving their goals.
- Valuing their diversity.
- Finding solutions that work for them.
Individuals have the right to be involved in everyday life activities and relationships as independently as possible.
Individuals are active, not passive, partners when it comes to their own care and support.
Individuals are the experts, as they know what matters most to them in their lives. For example, ask the individual if and how they would like to celebrate birthdays or special occasions instead of assuming or telling others about the event without their permission.
Self-care
If an individual has the ability to control and care for themselves, this will contribute to their privacy and dignity.
Self-care means the practices that an individual can undertake to help them:
- Be responsible for and maintain their own health and wellbeing.
- Keep both their body and mind fit and healthy.
- Manage their own care needs.
- Prevent illness and accidents.
- Take better care of themselves if they become ill or have a long-term condition or disability.
Self-care skills
As a health and social care worker, you should enable the individual to live more independently by supporting them to make their own choices and develop self-care skills.
These skills can include:
- Participating in support groups and networks.
- Finding information.
- Accessing appropriate training.
Common Core Principles to Support Self-Care
The Common Core Principles to Support Self-Care have been developed by Skills for Care and Skills for Health.
These principles aim to:
- Enable all health and social care workers to make personalised services a reality.
- Put the individual at the centre of the care planning process.
- Recognise that the individual is the best person to understand their own needs and how to meet them.
Supporting self-care
As a health and social care worker, your role is to care for the individual’s physical, emotional and spiritual wellbeing.
You should also:
- Be positive, open-minded and respectful of other people’s attitudes and beliefs, especially when they are different from your own.
- Allow the individual to live their life the way they want, as much as possible. This includes getting them back to the best possible health so they can live a fulfilled life.
Stereotyping and prejudice
- Stereotyping – means having a particular opinion about a group and applying it to all those who belong to the group, e.g. women cannot park a car.
- Prejudice – includes disliking a person because they belong to a particular group.
Stereotyping individuals and being prejudice must always be challenged and have no place in health and social care.
Your own attitudes and beliefs can affect the quality of your work and standard of care you provide. It is vital to reflect on them to ensure that this does not happen.
Raising concerns
You must always provide the best possible care and support to individuals. However, you may face problems in achieving this and need other people’s advice.
If you have any concerns regarding an individual’s privacy or dignity, it is vital that you:
- Raise them with your manager, a senior staff member, a carer or a family member.
- Always follow the agreed ways of working.
You should always ask for additional support if you need it to improve the care and support you provide.
