Autonomy, Social, Emotional And Community Contact
Having regular contact with family, friends and the wider community outside of the home is a crucial part of living a fulfilled and healthy life. The home will do its best to provide sufficient opportunities for people to maintain and develop such outside contact if desired.
Autonomy: Derbyshire House aims to ensure that anyone living in and/or using our service has as much freedom of choice in their lives as possible, so long as this does not expose them or any other person to unacceptable risk.
All staff have a duty to offer people living here or using our service choices that are culturally appropriate to each individual including:
- How they choose to be addressed
- When they wish to go to bed and get out of bed
- What meals they would like
- How they use their spare time and who they spend it with
- How they furnish and decorate their personal bed/sitting rooms
- Who they wish to associate with
- Freedom to their own finances whenever able to do so
- The freedom to self-medicate if able to do so
None of the above choices, wishes and freedom will be restricted from individuals without good cause and any restrictions assessed will be discussed and/or referred to DoLS where necessary.
Religion and Beliefs: Every person has the right to freedom of religion and beliefs and this includes opportunities and facilities to practice religion as long as this is not offensive to others. We will do everything practicably possible to ensure that all individuals enjoy this right to the fullest. A lack of respect for religious needs on the part of any member of staff will be the subject of disciplinary action.
When gathering information for the Pre-Assessment of Needs, we will record information regarding any religious requirements so that we can assess of how we will be able help meet these needs.
Where necessary, we can provide people with the necessary space and privacy within the home to engage in personal religious practice such as prayer, worship, meditation or the reading of scriptures. We have several fortnightly and monthly religious services held at Derbyshire House such as: Holy Communion, Evangelical church services and hymn singers. We will also make every possible effort to provide any dietary requirements which are based on a person’s religious beliefs or ethical background, and to help them to observe special festivals an anniversary related to their faith or belief. No person has to participate in any religious activity if they do not wish to.
At the end of life, religious belief and practice may assume a particular significance, and any requests for special treatment, ritual, or family and community contacts will be recorded within the future wishes clearly and concisely and communicated to the staff and GSF team. It will also include, where necessary and requested by the individual, the wishes of their friends and relatives, so that people at end of life who have any disability or communication difficulties can retain the importance of their faith.
Respect for individual religion, belief, ethical background and personal preferences and choices is considered a right for all people in our care and is a mandatory part of expectations of all staff within their role, no matter what job title.
Having social contacts is a crucial part of living a fulfilled and healthy life.
Derbyshire house employs butterfly staff, to be able to provide a social outings and stimulation. We also expect all staff to provide social contact with encouragement and opportunity to mix and seek friendship and pleasure in each other’s company.
Suggestions and ideas for social activity are obtained through individual choice, cultural belief and choices needs or individual interest and we support a wide range wherever practicably possible and restrictions allow, including:
- Trips to the garden centre, supermarkets and parks
- Visits to local village where there are cafes and pubs and shops
- Religious services
- Garden fetes, Xmas fetes, where members of the community/public are invited
- Afternoon teas
- Visits to local theme parks or attractions, such as Cadbury’s world or the arboretum or zoo
- Wild life encounters
- Lunch or dinner out
- In-house regular arrangements from musical entertainers or exercise to therapy animals
- Outside advocacy visits regularly to the house
People who prefer quiet times have their wishes respected and a range of facilities can be offered which they can enjoy on their own, taking our dogs for a walk, reading, sitting in the garden or watching TV.
Social contact is also provided through healthcare with weekly ward rounds GP calls and where necessary visits from the GP and/or district nurses and we also have visits from other health professionals, including opticians, foot health professionals, hairdressers, and access to dental services, as well as arranged appointments for health that individuals need to attend and are supported with arrangements for attending.
Social contact and inclusion is a mandatory part of expectations of all staff within their role, no matter what job title and is considered as paramount to the needs of all people.
Relatives and friends
We believe that each person should be able to maintain relationships with relatives and friends at a level they, themselves, decide and they should be consulted and involved in aspects of the assessment and care of the individual if they wish them to. We see relatives and friends as partners in caring for the people living with us and value and seek to encourage their involvement in the life and work of the home and we undertake ways in which to deal, considerately, with the relatives and friends of individuals.
Staff will only communicate with a relative and/or friends of a person living here with their permission and will always respect the right to privacy, particularly in relation to information about them held by or known to the home. Subject to those limitations we will attempt to involve named relatives and friends in all appropriate areas.
We will be responsive to information provided by relatives and friends during any further assessment or re-assessment of an individuals’ situation carried out during their period of residence in the home.
We will involve appropriate relatives and friends in drawing up, reviewing and implementing the care plan, culturally appropriate needs and life history of the individual to whom they are related or connected to were requested or agreed.
We will involve appropriate relatives and friends in aspects of day-to-day care of the person when this is what they and the individual wish.
We will record names and contact details of relatives and friends with whom the individual wishes us to communicate and establish with them and with the individual the circumstances in which they are to be contacted about any significant development.
No restrictions will be placed on contact between an individual and their relatives and friends except at the request of the individual or where there is a medical or health need for example, an infectious disease.
We will be particularly responsive to the need to involve relatives and friends at times of the increasing infirmity, terminal illness or death of a person, will show sensitivity to any special requests, rituals, cultural practices or required methods of care associated with dying and death, and will try to respond to the needs of relatives and friends after the death of a loved one.
We will systematically seek the views of an individual’s relatives and friends on the services the home provides and incorporate this material in our quality assurance procedures.
If an individual expresses a wish that the home should have no further contact with a relative or friend that wish will be respected.
If an individual expresses a wish to cease to have contact with a relative or friend, we will support them in carrying out that decision
If it is apparent or suspected that an individual is suffering any form of abuse from a relative or friend, we will take all the necessary steps to investigate, to protect the individual, to report to the relevant authorities and to collaborate in any subsequent investigation and action.
We will respect the right of the individual at any stage to appoint a representative to deal with the home on their behalf, and we recognise that this may be someone other than the relatives and friends with whom we had previously had contact with. We will provide, if necessary, information to individuals, relatives and friends about the independent advocates who can act on their behalf and about self-advocacy schemes.
Visiting and visitors
All visitors are made welcome and comfortable during their visit and are treated with courtesy and respect, whilst recognising that the home has a duty of care to protect people living or using our service and staff from intruders and anyone who threatens their safety and security.
Individuals may receive visitors at any times that are acceptable and reasonable to them and no general restrictions are imposed unless there is a medical or health need out of our control, for example, an infectious disease, in which case, we will implement restrictions and changes accordingly and notify these, hopefully temporary, changes through our newsletter, reviews or individual contact. Derbyshire House operates protected mealtimes which asks that unless the visitor is eating meals with an individual, visiting is avoided between 11:30am-1pm and 4.45pm-6.00pm. There may be occasions when a person may find it difficult or inconvenient to receive a visitor which is always respected, for example, because of ill-health or current circumstances. However, any such decisions to refuse or defer access will be determined by those individual circumstances and the wishes of the individual living here will always remain paramount.
Individuals have the right to receive visitors in the privacy of their own room and for the purpose of the visits to remain private. Where it is inconvenient or uncomfortable to use the persons’ own room, for example, because of numbers, the home will arrange for a more suitable place in accordance with their wishes.
There may also be a rare occasion when a care provider or member of staff believes a visitor may pose a risk to the resident, other residents or staff. The senior staff member may in the first instance talk to the visitor and try to resolve the issues. Where they cannot be resolved, the manager may want to consider placing some conditions that restrict the visitor’s ability to enter the premises. All actions should be recorded on a risk assessment and may require contact with the local authority.
Staff should only make enquires on the nature and purpose of any visits where the person living here is evidently vulnerable to harm or injury or there is evidence that they may have been subject to some form of abuse as a result of a visit or the actions of a visitor – this would include emotional or financial abuse.
Normally we will get to know who an individual has or wishes to have as a visitor so there may be no reason to always enquire in to the nature and purpose of the visit. Where an individual receives a visit from an apparent stranger or at an unusual or irregular time it is appropriate to ask them first whether he or she wishes to receive the visitor. In coming across strangers, it may be appropriate and reasonable for staff to enquire about the identity of the person and the nature and purpose of the visit, especially if the individual living here is uncertain or confused by it. For example, this might happen in the case of visitors who are cold calling for commercial purposes. The cardinal rule in always to consult the individual living here or their representatives whenever in doubt.
At Derbyshire House all staff are expected to treat every visitor courteously and to make them feel welcome and comfortable. Where visitors have to wait to see the person that have come to see, they should be offered a comfortable seat and refreshments. Where staff encounter someone, they do not know or who seems lost or uncomfortable in the building it is appropriate to ask them politely whether they need help and whom they are there to see. For visitors to feel more at home and comfortable at Derbyshire House, there are facilities to be freely used, for example, an open kitchen with facilities to make hot drinks.
Visitors are able to bring young persons or children in with them to visit an individual who are welcomed. Responsibility for the children/young person remains with the visitor with whom they have arrived and they must be supervised at all times. Should staff recognise any signs of neglect or abuse of the children/young persons, we will abide by our duty of care to safeguarding and our policies for young people. Where required, we would report any safeguarding issues to the necessary authorities.
We make a positive effort on fostering good working relationships with the local community as a whole.
The local church’s provide religious services. The local schools provide contact with the children and residents of the home, weekly. Residents are able to visit the local village and use the local business and amenities. We also help support the community during fetes and Christmas fayres.
Psychological and emotional care is central to the needs of all residents and Derbyshire House bases its ethos on the delivery of feelings-based-care.
All staff are expected to be culturally competent to the identified needs of individuals and have empathy and understanding as a natural skill and should use this as everyday normal practice to provide an environment for people who live here and use our services, that is meaningful, provides a sense of worth, encourages emotional strength and is individually fulfilling and not a life prescribed by others.
To develop psychological and emotional health, all staff have a responsibility to:
- Encourage and provide opportunities to develop relationships with others
- Encourage and provide domestic and work-like activities to give a sense of worth i.e. preparation of vegetables for lunch, cleaning/washing pots, gardening or shopping. Some residents like involvement with the home’s pets and the care of these as well as visits to the vets and this should be encouraged.
- Allow and support/guide residents the right to take risks where there is a recognised need. That does not put the resident in imminent danger – risk assessments should be carried out prior.
- Allow freedom of choice, respect wishes and empathise to individual feelings.
- Allow people to control their own life/choices as far as is reasonably practical, do not prescribe personal choices for others, respect individual wishes
- Let people be heard, listen and do not correct, live a person’s reality respectfully and with dignity
- Spend time, being with people, share stories and history. Remove barriers of “them and us” and task-based care.
Remember staff work in residents’ homes – residents do not live at staffs workplace!