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Unit 16
Support individuals to access and use services and
facilities
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Unit purpose and aims
The unit introduces the importance of supporting individuals to access, use services and
facilities and support them in reviewing the services they receive.
The learner will:
1. Understand factors that influence individuals’ access to services and facilities
2. Be able to support individuals to select services and facilities
3. Be able to support individuals to access and use services and facilities
4. Be able to support individuals to review their access to, and use of, services and
facilities
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1.1 How accessing a range of services and facilities can be
beneficial to an individual’s wellbeing
Enabling the individual
In order to support the individual, it is important to establish their wants, needs and
wishes, and how best you may assist them in accomplishing these choices. This is a
collaborative relationship between the care worker, the care team and the individual
where direction will be driven by the personal desires and goals of the individual. It should
be an empowering relationship where the person feels that they have the support they
require, in order to access a range of choices without having these dictated to them or
directed on their behalf. Support is to help individuals to become active participants in
their own lives and in the life of the community.
Many individuals find that due to mental or physical illness, disability, frailty, or other
changes in their circumstances, their ability to cope also changes. This may impact on
their mental or physical health and wellbeing, and a deterioration may result.
Access to services and facilities they once achieved independently, may be more difficult,
so the identification of new and existing services and facilities, may require support from
the care worker and others.
There may be many reasons why individuals need support to identify services and
facilities they need, such as:
Inability to access information and services themselves, due to physical or
mental health problems or disabilities
Not realising they need support or that support is available to them
Unsure of the support they require; they may need guidance to help them decide
Alackofawarenessofthetypeofsupportavailableandhow,andwhat,theyareentitledtoaccess
Their physical or mental condition may prevent them from identifying services
independently, or accessing the necessary information
Lack of confidence, low self-esteem
Understanding or memory impairment
Cultural, religious or personal beliefs may become a barrier to asking for or accepting
support
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Anxieties and worries over the financial cost of services
Lack of trust:
- dealing with strangers (social workers/care workers)
- fear of the unknown
Embarrassment:
- feeling loss of independence
- dependence on others
Lack of social skills
Literacy problems
Sight or hearing problems
Speech and language problems/differences/difficulties.
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Many people find themselves struggling to cope (either physically or mentally) because
they are not getting the support they need and don’t know where to turn for help.
Individuals can be very proud of their independence and be too embarrassed to ask for
help. Therefore, it is important that the need for services and facilities is recognised by
care professionals, as early as possible. Identifying the support required, and requests
for support, may come from a number of sources:
The individual themselves
Family, friends, neighbours and others
Care workers/key workers/the care team
General Practitioners
Hospitals
Social workers
Occupational therapists
Physiotherapists
Speech and language therapists
Other care professions e.g. health visitors, mental health workers.
Physical benefits
The meeting of physical care needs - enhances comfort and prevents the
deterioration of health and wellbeing
Identification of changes in the individual’s condition
Prevention of complications of immobility e.g. pressure sores, thrombosis, chest
infection, joint stiffness, pain etc., by practical help, exercise and the provision of
aids and equipment
Maintenance of the ability to self-care/self-manage
Maintaining adequate nutrition - prevention of malnutrition
Identification, treatment and prevention of foot problems
Identification, treatment and prevention of tooth, gum and mouth disease
Maintenance of physical skills
Pain relief
Relaxation and rest.
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Mental and social benefits
Identification, treatment and prevention of mental health problems
Mental stimulation - boosts confidence and self-esteem, improving social
skills and maintenance
Building of relationships
Maintaining independence
Reduction of levels of stress and anxiety
Improved access to education and employment
Meeting spiritual, cultural and religious needs.
General improvements in the individual’s ability to express their needs and to
communicate with others will occur if services that address communication, speech and
language difficulties, sight, hearing, memory and understanding impairment are made
available to the individual, along with any relevant information.
Informal carers such as family and friends will also benefit, as services provide
practical and emotional support.
Services and facilities may also provide financial advice and help and protect
individuals from danger, harm and abuse.
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1.2 Barriers that individuals may encounter in accessing services and
facilities
Networks and support services
It is very important that you explore the strengths and weaknesses of the individual’s
existing networks and support systems.
Some services may already be provided; for example, by social services, the primary
care team, care home, the private sector, charities etc. Discussing the strengths and
weaknesses of the services with the individual and liaising with service providers,
together with your own observations, will help to determine the strengths and
weaknesses, and identify any gaps. These gaps may result in an unmet need due to
inappropriate/insufficient/inadequate services and facilities, or the absence of necessary
services and facilities altogether.
The networks and support systems may be provided by family, friends and informal
carers. It is essential that you discuss needs with the individual and their information
networks (friends, family etc.). The individual may feel that the service a loved one
provides is sufficient, but an elderly overworked, overstressed, wife/husband/daughter
may be struggling to cope, and the care and support the individual receives may break
down if these ‘gaps’ are not addressed. Relatives may be able to provide excellent care,
but not at certain times of the day, due to their other commitments such as work, family
etc., or their own health problems. For instance, overnight care may put great stress on
the physical and mental health of an informal carer. Alternatively, carers may live far away
or not have transport. Services or facilities such as home care, day centres, transport etc.
may fill these ‘gaps’ and improve the quality of life for the individual and others.
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1.3 Ways of overcoming barriers to accessing services and facilities
Services and facilities
There will be a great many services and facilities available to individuals, both within and
outside your care organisation. The vast majority of services and facilities, or their
equivalent, which are available to the general population, should also be available to
individuals in your care, if they wish to access and use them. For example, an individual
who is virtually bed-bound should not be prevented from accessing a minister of religion,
buying new clothes or watching a film, if this is their wish. However, watching a theatre
show may not be possible if their health prevents this.
It is your duty, as a care worker, and the duty of your care organisation, to ensure that
individuals know about services and facilities, are able to identify those they need and
can safely access and use their chosen services and facilities.
Services may include:
Emergency services, police, ambulance, fire brigade
Public transport
Banks and buildingsocieties
Shops
Hairdressers,beauticians
Leisure centres, swimming pools,gyms
Churches, places of worship, ministers of religion
Sports, social and charitable clubs and societies
Schools, colleges, universities, other education establishments,tutors
Doctor’s surgeries, clinics,hospitals
Therapists - private and national health services e.g. counsellors, osteopaths, chiropodists, physiotherapists
Council offices and departments (Environmental Health, housing)
Government offices and departments
Job centres, employment agencies
Lawyers,solicitors
Financial advisers
Tradesmen - builders, plumbers,electricians
Primary Health Care Team
Optician
Dentist
Sports facilities
Entertainment venues - cinemas, theatres, pubs, nightclubs, dancehalls, bowling alleys
Libraries
Internet cafes
Restaurants, cafes, coffee bars
Parks, open spaces
Museums, art galleries
Chemist,pharmacy.
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Within the care organisation there may be facilities and services available to
service users, including:
Speech and language therapist
Physiotherapist
Occupational therapist
Care team (manager, nurses, care workers, key workers)
General Practitioners
Hospital specialist (e.g. surgeon)
Social workers
Charitable organisations
Pharmacist
Cleaning and security services
Translators, interpreters.
External services
There will probably be a number of external services that visit your care
organisation, or individuals in their homes. These services will vary according to
the nature of your care organisation and the services required by the person.
Available facilities and amenities
What each person is able to do will depend upon a number of factors; primarily, the
facilities within the establishment and the local community or surrounding area, an
individual’s mobility, ability and degree of motivation.
Many towns have social clubs run by a local authority, voluntary organisation or the
church. Activities in them vary, though many focus on activities such as bingo,
gardening, community singing or entertainment provided by local talent.
Within your care organisation, individuals may be undertaking a number of activities on
the premises. Alternative areas, which afford privacy, should be made available. Ideally,
there should be areas where individuals are able to cook or make refreshments.
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There should be facilities for individuals’ guests and arrangements must be made for worship.
Areas where people can dine, have access to bathrooms, toilets, bedrooms and
common rooms should be easily reached from where the activities are taking place.
Risk assessment
Where you are providing a service to an individual, it is necessary to be responsible for
considering their welfare and safety. If an individual expresses a desire to undertake a
new venture, it is necessary to assess the risk that may be involved for that individual. It
is essential to balance their rights and choices against the possible risks involved and you
should provide advice about any possible risks, and the means of reducing these risks.
Risk assessment should be carried out for any new activity that the individual wishes to
pursue, and any advice provided should be agreed with the individual, and documented.
Ultimately, the individual has the choice to accept or ignore our advice, but all parties
should be aware of the identified risks and make informed choices based on this.
It is important that you examine, with individuals, any risks involved in the services and
facilities they prefer. These risks will be assessed with health and safety in mind. Physical
and mental health problems and disabilities may have a direct impact on the health and
safety of the individual in all aspects of their daily lives, including recreational activities.
These may include:
Changes in their mobility - restrictions to the distance a person is able to walk, the
length of time they are able to stand, unsteadiness on their feet and risk of falls,
unable to weight bear
Loss of movement in limbs/hands - deformities of limbs/hands, grip may be affected
Problems with fine movement/co-ordination
Sensory impairment affecting:
- Eyesight
- Hearing
- touch (loss of sensation - hot and cold – affecting grip)
smell/taste - unable to smell burning - detect odour of food - e.g. sour/rancid.
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Whilst it is well recognised that exercise benefits health, certain types and levels of
exercise may affect certain conditions. This may mean that either a service can be
modified, or access improved (transport etc.) Adjustments made by the individual
themselves (e.g. to medication and/or diet, as in diabetes/asthma etc.), or a new service
considered. Conditions that may be affected by certain activities, either adversely or
beneficially, may include:
Heart disease
Arthritis
Lung disease (e.g. asthma)
Pain
Diabetes.
All of the care team should be aware of, and take into consideration, any condition that
may be affected by activities undertaken.
Other aspects may create health and safety risks, such as:
Understanding and memory impairment - may mean that an individual could be at
risk because they forget or do not understand instructions, and basic health and
safety advice - may affect the use of aids and equipment
Mental health issues - lack of insight -self-harm or harm to others. May affect the
choice of service or facility
Poor personal hygiene - may be a particular problem, if food preparation or using
communal facilities (e.g. swimming pool) are involved
Young children or those with learning difficulties - may be at risk of injury when
accessing certain services or facilities.
The individual may wish to access and use a service which poses a health and safety
risk to themselves and is inconsistent with the plan of care. If this is the case, the
manager must be informed immediately.
It may be that individuals recognise and accept the risks, but are unwilling to give up their
chosen activities.
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It is very important that individuals are discouraged from undertaking activities which
pose unacceptable health and safety risks. Some people are vulnerable; therefore, you
have a ‘duty of care’ to protect them. Ensure that your concerns are reported
immediately and action is taken to prevent this activity from taking place. Other less
vulnerable people will also be offered alternatives and the risks clearly explained to them
by the manager. If, however, they choose to go ahead, they must understand that they
take full responsibility for their actions. Records must be made and other services
informed, if a solution cannot be reached within the organisation.
Managing risks
Once identified, risks must be managed. Managing may not necessarily mean
eliminating risks altogether, but may involve reducing the risk to the lowest level
possible. Risks may exist for every individual undertaking activities, including you.
Methods of managing risk may involve:
Carrying out a risk assessment
Adhering to any recommendations, following a risk assessment
Providing aids, equipment and support
Educating the individual to act in a way that reduces risk
Adapting the level of supervision to suit individual needs
Not undertaking activities if you are not satisfied that risk is reduced sufficiently -
recording and reporting immediately
Discouraging individuals from going ahead with risky activities and explaining why -
discuss the risks and plan how they can be reduced.
Risks may be many and varied and include:
Crossing the road
Accessing and using public transport
Falls risks
Safety and security - allowing others into their home/room in care home - may be
vulnerable
Using aids and equipment.
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1.4 Supporting individuals to challenge information about services that
may present a barrier to participation
Accessing and reviewing information
The greatest problem an individual may have in relation to accessing and using services
and facilities is accessing relevant information. Quite often people struggle on without
help because they don’t know what help is available, who they ask or how they find
information.
It is important that you provide the link between the information, the access and the use
of the service or facility, and that you know how to access and review information before
it is provided to the individual. You may need to prepare yourself to review relevant
information by speaking with senior colleagues and asking any questions or raising any
queries you or the individual may have. It is vital you do not offer a service that cannot be
delivered. Find out first what the individual wants and what services are available to meet
thatneed.
Finding information
It cannot be assumed that the individual wishes us to provide the information for them. It
may be manageable for the individual to research their chosen goal and find the details
for themselves. Where it is possible for the individual to achieve a task independently,
this should always be encouraged. Once again, it is important to establish your role in
supporting the individual.
If we are providing information, it is imperative that this is current and relevant for the
individual. It is good practice to maintain a current stock of leaflets and information on
local resources and facilities which may be of use to your service user group. It is also
important to remember that there will be other resources of interest that you do not hold
current information about. Additional research will be required to update and broaden
your available information bank, and to address specific requirements of the individual.
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Whether the individual requires support or is accessing information independently,
consideration must be paid to the individual’s requirements, with regard to accessibility of
information. Issues to consider include:
Will the individual benefit from written, verbal or pictorial information
Does the individual have any literacy support needs
Does the individual have any sight impairment
Is the print large enough for the individual to read
Is the information easily understandable
Is written information provided in the first language of the individual
Does the individual require support in using written information? Is it necessary
to read through information with the individual
Can the information be available to the individual at the time required
Does the information available meet the requirements that the individual had
originally expressed?
Wider issues may include those relating to physical access and personal limitations
experienced by the individual, such as:
Can the individual access the building or location where the required information is held
Is disabled access to the location available if required? Are there any other
environmental limitations
Are sight/hearing/speech difficulties supported
Are there any other limitations? E.g. anxiety, agoraphobia, panic disorder, seizures
Is the information available locally or is travel necessary and/or possible
Is there a charge involved for obtaining the information, or for travelling to obtain it?
Using and reviewing the information
It is necessary to establish if the collated information is useful to the individual. Talking to
the individual about their understanding of the information and its relevance, is essential.
If additional support or extra information is needed this can then be arranged. Individuals
should be encouraged to request further information as necessary, in order to help their
choices. The individual may wish to contact a service indirectly i.e. by letter or telephone,
or directly i.e. by attending the service to check its suitability.
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Support should continue to be provided to the individual, if required, in order to enable
them to access services and make choices about how appropriate the available
services are to them. Good preparation and support of the person, with their lead, goes
a long way to ensuring that information is relevant, up-to-date and specific to them.
Regular discussion and review with the individual will allow any changes to be
recorded and actioned. However, there is always the possibility that an unplanned
situation will arise.
2.1 Working with an individual to identify a range of services and
facilities likely to meet their assessment needs
Assessing the needs of the individual
Holistic care
It is important that the whole care needs of the individuals are met. Care should be
planned to take into consideration their spiritual, psychological and social, as well as
physical, needs. This means looking at the individual as a whole person, rather than
just focusing on their medical condition.
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In order to provide holistic care and develop therapeutic relationships with
individuals’, it is important that care workers find out about their needs, wishes and
preferences.
Assessment of needs
It is vital that the needs of individuals are assessed, and a plan of care developed. All
members of the care team should take part in this process and understand and are
supported in implementing the plan. Taking a comprehensive history during the admission
process will assist this and any difficulties may be highlighted.
Before you even talk to the individual, you will make your own personal observations
about that person. Getting to know the individual will help you to understand their
needs.
Preparation
Obtaining accurate information from appropriate sources at appropriate times, can help
the care team to prepare for an individual, or to obtain the expertise of those who provide
specialist services and therapies. The need for third party translation, interpretation and
advocacy services may be identified.
Depending on your role, you may be required to collect information from individuals as
part of the admission process or prior to a review.
You may collect information in a more informal way - chatting with individuals and their
families, or from your own observations. For example, you may have noticed that an
individual has long, toughened toenails they wish to have cut, or you may be caring for
someone who is socially isolated and expresses feelings of loneliness. An individual may
have discussed an interest or hobby with you or the family may have brought certain
problems or difficulties they have with caring, to your attention.
The most important aspect of supporting individuals to identify services and facilities is
listening to them and putting their views and opinions at the centre of decision-making.
Allowing an individual freedom of choice is essential. It is their right.
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You have a responsibility to ensure that when working with people, you do not forget that
they are all individuals first and foremost. These individuals do not cease to have the right
to make choices or decisions because they have become a service user. Many people
may have lost their ‘voice’ and are unable, or feel unable, to express their views.
These may be:
Through ill-health and infirmity
Impaired awareness of surroundings due to illness
Loss of function e.g. sight, hearing, speech, mobility
Loss of confidence through physical or mental health difficulties
Limited need to air their views due to reliance on others to choose for them
Impaired understanding due to illness.
You can enable the individual to retain their individual choices in many ways:
By always remembering that the person is an individual with personal preferences,
aims and needs unique to them
By asking what the individual wants to achieve and what degree of support they require
By understanding and respecting the individuals unique perspective of their needs and
wishes
By providing useful information about options available to them
By ensuring that information is available in a format which is understandable to the
individual
By making time to discuss presented options to help the individual to make an informed
choice
By respecting their views, if they have preferences for certain choices offered, or decline
others.
If an individual feels they are consulted and involved in planning their needs they are likely
to feel more motivated and empowered in their choices. It is reasonable (and expected)
that you will encourage your individuals to be motivated and make positive choices.
However it must always be remembered that their choices may differ from your own belief
about what is ‘good for them’. By showing empathy for the individual, you can become
more aware of how you might feel to be in their position which can help you to respect and
support their choices.
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Monitoring, recording and reporting of any problems with accessing rights is essential
to ensure individuals’ rights are upheld.
Support services
Other agencies who may assist you in supporting the rights of individuals include:
Social workers
Community nurses
Primary Care Team
Psychiatric services (community psychiatric services)
Courts
Interpreters
Translators
Community groups
Charitable organisations
Advocacy services.
By discussing with an individual, their aims and desires, you can find out what they
perceive their needs to be and the degree of support they require.
Remember, support can take many forms and cover a wide range, such as:
Listening to and acknowledging and agreeing the support an individual has
identified independently
Guiding, advising and offering information and explanations, making
suggestions and encouraging an individual to make decisions/choices
Acting as an individual’s advocate.
Although identifying what support an individual needs may seem obvious to you and the
rest of the care team, this may not be so for the person. Individual’s choices, wishes,
needs and opinions must be respected, and efforts made to discuss and offer
explanations to the person on why you think a service is necessary. The individual has a
right to refuse support. However, this must be reported, especially if accessing and using
a service to meet a particular need is thought by the care team to be essential to maintain
the health, safety, security and wellbeing of the individual.
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2.2 Agreeing with an individual on their preferred options for
accessing services and facilities
Agreeing services and facilities
The most important part of agreeing services is the choice of the individual. There is little
point in care staff choosing services and facilities that the person does not feel they need,
or wish to access.
You can enable the individual to retain their individual choices in many ways:
Always remember that each person is an individual, with personal preferences,
aims and needs specific to them
Ask what the individual wants to achieve and what degree of support they require
Understand and respect the individual’s unique perspective regarding their needs and
wants
Provide useful information about options available to them
Ensure that information is available in a format which is understandable to the individual
Make time to discuss presented options to help the individual make an informed choice
Respect their views, if they have preferences for certain choices offered, or decline
others.
If an individual feels they are consulted and involved in planning their needs they are
likely to feel more motivated and empowered in their choices. It is reasonable (and
expected) that you will encourage individuals to be motivated and make positive choices,
but it must always be remembered that their choices may differ from your own belief on
what is ‘good for them’. By showing empathy for the individual, you can become more
aware of how it might feel to be in their position which can help you to respect and
support their individual choices.
Respecting the choice of the individual
Individual preferences also need to be taken in to account. The individual may have a
number of personal preferences when considering what services and facilities may be
appropriate to them.
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For example:
Religiousbeliefse.g.aJewishpersonmaynotwishtoattendagroupheldinanAnglicanchurch
Personal life experience influencing choices e.g. an individual who has experienced
alcohol misuse may not wish to attend a group or activity held in a public house
Moral beliefs e.g. deciding to rule out attendance to a particular group because
you do not concur with all of their actions and beliefs
Personal grounds - a reason may not be given, as is the individual’s right. This
may be a private matter or simply that the individual declines a particular option
through personal preference.
There may be many other possibilities relating to individual choice and preference.
Discussing possible preferences and ideals with the individual can give some idea of the
kind of facilities which may be appropriate for them, and those which they may choose to
dismiss. All options should be made available. The choice to accept or exclude an option
should be with the individual and not the care worker.
Conflict of interest
A difference of opinion may arise if the individual refuses an option, apparently without
due consideration. You may consider that the individual has been dismissive of the option
and has not viewed the possible benefits. Likewise, it is possible that you could positively
or negatively represent a particular service or facility because of your personal view of the
relative benefits. To provide an enabling environment, it is necessary to uphold the
principle of respecting the choice of the individual by presenting objective information
about all options available, and for them to make their own choice.
You, as a care worker, must work with the individual to agree options, following a
thorough review of relevant information, taking into consideration any health and safety
risks that need to be managed.
It is important that you provide guidance and support, but do not decide for the individual.
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2.3 Working with an individual to select services or facilities that
meet their assessed needs and preferences
Selecting a service or facility
Once an individual’s preferred options have been identified, you can work with them
and key people to select a service that will enable their assessed needs to be met.
Selecting recreational activities
Individuals’ experiences of illness and disabilities may have affected not only what they
are able to participate in, but also their confidence, motivation and self-esteem. They may
feel anxious, or that they are not capable of participating.
All individuals have the right to choose, to be treated equally and not discriminated
against, regardless of their physical or mental health, culture, race or religion, or their
choice of activities.
Although it may not always be possible to accommodate all the preferences of the
individual, choices must never be limited due to the result of unfair discrimination.
You, as a care worker, must ask questions, give encouragement, explanations and
information, and also address queries and concerns.
Accessing and using new services and facilities
Trying something new can be a daunting experience. This can be particularly so for
individuals adjusting to many changes in their lives.
Encouragement, support and information about the activity will help the individual
to gain confidence, as they know what to expect and what is expected of them.
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3.1 Identifying with an individual, the resources, support and assistance
required to access and use selected services and facilities
Active support
Identifying support
It is vital that you provide active support for individuals to access and use selected
services and facilities. Good, open and honest communication between the individual
and the care team is imperative for establishing the support they believe they need.
It is essential that the care worker and individual can agree on the support the individual
requires. This will avoid misunderstandings, reduce the likelihood of conflict and increase
the chances of a successful outcome.
It must be remembered that the support a care worker believes an individual needs may
be quite different from their perception. The only way you are going to establish this is to
talk to and listen to them.
Patient discussion and tactful suggestions should help reach a satisfactory
solution for all. Compromises may need to be reached, remembering that these
must also be taken into consideration when support is identified.
Preparation
Care planning
It is important that any planned services and facilities are consistent with the individual’s
care plan. They should be realistic, achievable and appropriate to the individual’s needs,
interests, understanding and abilities.
There may be a variety of reasons why a person chooses a particular service, such as:
A continuation of an existing service
Similar to what they have done in the past
A challenge
Achievable
To try something new
Something they have always wanted to do
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Changes in personal circumstances or situation may require a new service or facility
Improve personal skills, knowledge and education
Improve physical and mental health and social wellbeing..
This said, all services will only be attractive to the individual if they are perceived as
enjoyable and/or beneficial to them.
The choice of service and facility should be the individual’s choice. However,
consideration must be given to whether the individual will have the capabilities to
continue with previous activities and if so, in what capacity they are able to participate
safely.
The individual may no longer have the physical or mental capacity to continue certain activities.
However, it may be possible for individuals to continue to use a service such as a
recreational or leisure facility/activity by participating in a different way, such as:
Spectating
Organising
Teaching, coaching
Fundraising.
It may be possible to offer an alternative service and facility that is acceptable to the
individual and care team.
Support
It is essential to identify what support an individual may need, to continue, in some
capacity, any existing activities. Support may include:
Specialist aids and equipment to aid sensory impairment (poor eyesight/hearing
etc.) and physical disability
Increased supervision
Practical help and guidance
Assistance with mobility and transport
Financial assistance
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Support of professionals e.g. occupational therapist
Support to address mental health problems, such as depression (causing poor
motivation)
- This may require referral to the psychiatric team.
New activities, services and facilities
Sometimes it may not be possible for an individual to continue with an existing service or
they may prefer to try something new. The individual and care team need to identify and
examine what new services and activities will best meet their needs. This may be done in
a variety of ways. For example:
Suggestions made by the person themselves, their family and friends
Information available within the care establishment
Information with regard to local leisure and recreational activities
Information available from disability groups and charities.
Available facilities and amenities
What each person is able to do will depend upon a number of factors; primarily, the
facilities within the establishment and the local community or surrounding area, an
individual’s mobility, ability and degree of motivation.
Many towns have social clubs run by a local authority, voluntary organisation or the
church. Activities in them vary, though many focus on activities such as bingo,
gardening, community singing or entertainment provided by local talent.
Within your care organisation individuals may be receiving a number of services on the
premises. Alternative areas which afford privacy should be made available. There should
be facilities for individual’s guests and arrangements must be made for worship.
Individuals should be encouraged to choose and plan how they can access and use
facilities and services, with help and guidance from staff. These should be activities which
are realistic, achievable and suitable for the individual and the surroundings. The
frequency and standard of these services will depend on the knowledge and commitment
of the care worker, and the participation and co-operation of the individual. An individual
may wish to take part independently, staff led, alone or in a group.
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3.2 Carrying out agreed responsibilities to enable the individual to
access and use services and facilities
Preparation of the care worker
It is vital that you, as the care worker, understand what is expected, so that individuals
can be properly supported. You should also be aware of any health and safety issues.
Reading the care plan and confirming this with your manager will ensure that appropriate
activities are chosen.
The role of the care worker
The care worker should have a full understanding of their role. They must be aware of
whether they are expected to support or assist another member of the care team (e.g.
an activities co- ordinator, nurse, doctor, etc.), or whether they are expected to take the
lead in the planning and preparation of activities.
It is essential that the care worker recognises the limitations of their role and the
limitations of their skills. For example, a care worker who is unable to swim would not be
suitable for accompanying individuals to a swimming pool.
The care worker must be very clear on when assistance is required and who the
appropriate person is to report to, or seek advice from.
Documentation
Many services, especially if financial aid is involved, require forms to be completed. This
process can be very daunting as some forms appear lengthy and complicated, and details
required may be private and personal. This can cause great worry to the individual
concerned, especially if there are language barriers, literacy problems or sight
impairment. Difficulties such as these may result in an individual not accessing a service
or obtaining financial aid, as they are not able to fill in the forms. Other forms of paperwork
may enable an individual to communicate their needs or a part of using a service or
facility.
As a care worker you can help individuals and key people to fill in a variety of forms of
paperwork to enable individuals to access, use and evaluate services and facilities. Tact
and sensitivity are required, as people may feel embarrassed to ask for, or accept, help.
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If you are unsure, or recognise that what is required is beyond your role, you must seek
advice and support from your manager. Referral to other agencies such as social
services, council or educational departments may be needed.
3.3 How to ensure individuals’ rights and preferences are
promoted when accessing and using services and facilities
Using services and facilities
It is important that the care worker understands their role in the implementation of the
activities. Careful preparation of the individual and the environment is essential, as is
support before and during accessing.
Using resources
In order to use any resources available to us as individuals, we have to consider if
they are suitable to us in a number of ways. These could include:
Do we like the facility?
Do we have any objections to the policies or views held by the organisation or service?
Do we feel we would benefit in some way from using the service or facility?
Do we like the people there?
Is it an easy facility to get to? An easy service to access?
Will it cost us money? Can we afford any expenses involved?
Are we committed to the service if we begin using it?
Do we have any guaranteed service from the facility if we begin using it?
For an individual with a disability or illness, further considerations may arise, such as:
Can I manage to use this service or facility on my own?
Can I be sure I will be understood/will hear them/will find my way in an unfamiliar
situation?
Will I panic/have a seizure?
Will I be able to get access/will there be a ramp/will someone be there to help me
with the steps?
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It is important to encourage the individual to support themselves in the use of community
resources, as this fosters improved independence. Enablement allows the individual to
take control of their own choices and rights in the long term. Individuals who have come to
rely upon others to set their schedules and care for them, can fail to use their abilities, due
to over reliance on others. This is just one element of institutionalisation which is
damaging to both the mental and physical wellbeing of individuals.
However, in encouraging the individual, steps should be taken to minimise problems in
accessing services and facilities, wherever possible. Preparation to establish the possible
pitfalls can reduce the number of unexpected problems arising, can promote confidence
and foster a sense of achievement in the individual.
Information, guidance and support
Self-management and empowerment
It is vital that individuals are given all the necessary instruction, support and assistance
required to carry out their chosen activity, at a level and pace appropriate to them. It is
important to encourage them to be as self-managing as possible.
Giving too little support can leave the individual feeling frustrated and despondent.
Alternatively, too much support may result in them feeling they are not achieving and
that you are suggesting they are not capable.
The person must feel in control and able to set the pace. Empowerment of the individual
is vital. The plan of care must be read thoroughly and discussions must take place with
senior staff, the care team and the individual, before the activity commences. This will
ensure that the support individuals require is established.
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In encouraging the individual to develop their independence, it is also important to
make goals manageable and realistic. An appropriate time-scale must be set, and this
must arise at a time when the individual can best achieve their personal aims without
feeling pressured or rushed to complete a task.
The required level of support should be agreed with the individual in advance. This can
take some negotiation, as the individual may not know how much support will be required
until they are undertaking a task. If actions are agreed to reduce problems in accessing
services, any physical barriers are addressed, then the remaining consideration can be
one of the individual’s confidence. Support may be required from a verbal prompt, through
to direct individual and personal assistance. Reassurances should be made that if the
individual is uncomfortable or needs more support, that this becomes available. Likewise,
if the individual manages well and requires some discretion from their support worker, this
can be confirmed.
Whenever a care worker assists an individual in achieving their goals this should arise in
a respectful manner with maximum discretion afforded to the individual. Steps should be
agreed to enable the individual to feel confident in their efforts, but to have additional
support available if required. If an individual manages well with a task, it is important that
you are able to step back and afford them this success. Likewise, if an individual struggles
with a task, it may be necessary to intervene with support, but this should happen in a
discreet and respectful manner e.g. ‘Is there anything I can help you with?’ or ‘Do you
want me to give you a hand’. It would not be appropriate for example, to state ‘I’m Mary’s
support worker and she is inclined to panic. I’ll take over from here’. Maintaining support
at the required level and observing the individual’s progress must happen in a sensitive
and professional way.
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4.1 Working with an individual to evaluate whether services or
facilities have met their assessed needs and preferences
Evaluation
It is important when care is planned and services and facilities agreed and selected, that a
method and timescale for evaluating how these have contributed to the individual’s
wellbeing, are agreed. One method of evaluation, or, indeed, one set timescale, will not
be suitable for all individuals, situations and circumstances. Each person will need to be
assessed individually and plans for evaluation made to suit that person.
This involves reaching conclusions based on the feedback reviewed following activities
during discussions between the care team and the individual. Evaluation is extremely
important as conclusions need to be drawn with regard to the benefits of the chosen
activity. Decisions need to be made about the effectiveness of the activity and solutions to
any identified problems. The evaluation will directly influence the future plan, ensuring a
person-centred approach to care planning.
Individual self-evaluation of leisure and recreational activities
Individuals must be supported and encouraged to evaluate their chosen service and
facility themselves. They must be reassured that their opinions are valued and their
suggestions and criticisms welcomed. The individual must not be made to feel afraid of
upsetting or offending the care worker by expressing concerns or admitting they did not
enjoy their chosen activity.
Some people may be able to discuss this in a group setting, whereas others may feel
more at ease discussing their feelings individually with a care worker. Certain care
environments may have a formal meeting system where individuals are encouraged and
supported by the care team to evaluate their chosen activity.
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4.2 Supporting an individual to provide feedback on their experience
of accessing and using services and facilities
Feedback and review
It is important throughout the use of services and facilities that you observe and talk with
the individual and key people, and obtain feedback. This will help to assess a number of
aspects such as:
The appropriateness of the service for the individual
How much help each individual requires
The level of individual participation
The communication, participation and co-operation between individuals in a group
setting
Whether the individual/key people expressed satisfaction/enjoyment
How the care workers perceived the individual’s satisfaction/enjoyment
Whether the goals set were achieved
The effectiveness of communication between the individual, the care worker and others
Any services and facilities which are less beneficial to the individual’s wellbeing
Any problems/difficulties arising from access and use of a service
Any concerns expressed by individuals or other care workers
The desire of the individual to use the service in the future
Any benefits identified by the individual and key people
Any changes preferred or considered necessary
Any discrimination or exclusion experienced by the individual.
Once all this information has been gathered, the care worker will have an overall
picture of whether the chosen service was suitable for the individual.
Review of leisure and recreational activities
After feedback has been obtained from the individual/group of individuals, it is important
to pass this information on to the rest of the care team. How this is done will vary
according to organisational policy, the individual’s plan of care and individual
circumstances. However, any problems or concerns experienced by the individual or
care worker should be reported immediately to the manager/senior member of staff, as
should any changes in the general condition or abilities of the individual.
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Most services have a requirement to demonstrate that targets are being met and that
their input is cost-effective. You may be called upon to review their care and justify your
input. Regular assessment and review of the individual will demonstrate which input has
been useful and what may need to be reviewed again. You have a duty of care to provide
input to the individual service user which is relevant and appropriate and to review that
input to ensure best practice is being upheld.
A review may be carried out informally on a one-to-one basis between care worker,
senior staff and service user, or formally in a pre-arranged review meeting. This meeting
may be attended by the individual, you (or the information you have supplied to be used
during the meeting), key workers, activities co-ordinator, manager or trained staff and,
possibly, others, such as occupational therapist etc. You must be clear about your
responsibilities in the review and fulfil these with the support of the care team. If you are
unsure of what is expected, ask the advice of your manager. Whichever method is used,
activities should be reviewed at regular intervals.
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4.3 Working with an individual to evaluate the support provided for
accessing and using services or facilities
Support and encouragement should be given to the individual to participate in the review
process. This will give a truly holistic view of the care planned and will enable any
necessary changes to be made.
One of the most challenging aspects of helping an individual to progress can be that
they may become too able or independent to continue to use the facility or resource
they originally accessed.
The main issue to address is whether any need is being met by continuing to use a
facility, and then to consider whether any outstanding or new needs could be better
met by another, more appropriate facility, for example, an individual attends a support
group for people who are experiencing depression, but has not felt depressed for the
last 8 months. Is it appropriate for them to continue to attend the group?
Things to consider may include:
Points for keeping the situation the same:
It may be that the individual has improved because they are in contact with a
group of people they have grown to trust:
- this may have helped them to challenge their depression
- To make a change now could develop new challenges and cause renewed
feelings of depression.
Points for change:
It is important that the individual continues to derive some benefit from the
facilities they utilise:
- to continue in the same situation if it is no longer useful could foster
dependence on the group and limit the individual in their long-term progress
- it may be time to move on to something else, now that the individual is coping better
- The individual may have something new to offer e.g. setting up a new group
for people who have experienced depression, but are now coping well.
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It is important to review progress with the individual and to make realistic suggestions for
timely change. The individual may be apprehensive about change, and may require
guidance and support in a new situation. Appropriate and consistent support, at the
required time, will enable the individual to make challenging choices with the confidence
of knowing that support is there, if they require it.
4.4 Identifying and agreeing changes needed to improve the
experience and outcomes of accessing and using services or
facilities
Agreeing changes
Once a need for change has been identified, or a desire for change expressed, what form
that change will take must be agreed. The change proposed should be realistic,
achievable, meet with health and safety requirements and be acceptable to the individual,
care team, key people and others.
Implementing changes
Any agreed changes should be discussed and agreed, and recorded in the care plan.
Each member of the care team, the individual and key people should fully understand
their role and responsibilities when implementing this change. As a care worker, you
must implement any changes you are responsible for, using a consistent approach.
Supporting individuals and key people through changes is vital.
If the agreed changes that are outside your responsibility are not being made, you
must take action. Report your concerns, monitor the situations, ask questions and
make a record.
Making changes
As part of the work team, you have the same right as everyone else to suggest changes
for improvement within your organisation. It will depend entirely on the change you have
proposed, your role and responsibility, and the impact the change will have on the
individual, whether the change is implemented.
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If you have an idea that is entirely within your area of responsibility, you may be able to
make the change. However, you must always confirm this with a senior colleague. If the
change is outside your area of responsibility, you and your colleagues will have to check
with your manager. Your change may have to be approved formally, and policies and
procedures altered. Whatever the proposed change, it must fulfill certain criteria:
It must be a genuine improvement
It must not have an adverse effect on another aspect/part of the team
It must be consistent with organisational policies and procedures.
Occasionally, you will need to accept that the change you are suggesting may not be
viable. This may be because you do not have the skills or expertise to make the change
or because it has a negative effect on your colleagues or individuals, especially if they do
not feel this change is required or necessary.
One way you can determine whether or not a change demonstrates a genuine
improvement is to carry out a period of action research. This may prove a more
acceptable way to introduce change that affects individuals and care workers.
Action research
This is a method of carrying out research within the care worker’s care organisation. To do
this, you will need to have the support of your manager, and the support and co-operation
of colleagues and service users.
There may have been many times when you have consulted and/or collaborated with
colleagues. Regular shift handovers and care planning meetings are examples of this.
Consultation and collaboration between colleagues and individuals benefits all levels
and grades of staff and, most importantly, the individual. Throughout, you have worked
closely with colleagues, consulting them about issues and collaborating during planning,
implementation and evaluation of activities.
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Recording, reporting and reviewing
Actions and outcomes from the evaluation must be reported on and a record made. You
must be clear about the records you are responsible for and how these are completed.
All records should be accurate, legible and complete, and meet with legal and
organisational policies and procedures.
Conclusion
The information you have read within this unit should increase your knowledge and
understanding which will benefit you, the individuals you care for, key people and others.
Now complete the assessment questions for this unit in the workbook section.
