NVQ Made Simple

Unit HSC27 Support individuals in their daily living

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Elements within HSC 27

a. Agree with individuals the support they require for their daily living b. Assist individuals in activities to promote their well being c. Help individuals access other support to promote their well being There are 12 knowledge requirements within this unit and you will need to show that you are informed about them all and you understand the applications likewise. K1. What are the legal and organisational requirements on equality, diversity, discrimination and rights when supporting individuals in their daily living?

There are set down legislations regarding the rights of service users that you need to follow when supporting individuals in their daily living that ensure that they are not discriminated against. You should observe that individuals have the right to be different and should be free from discrimination when you are supporting them in their daily living. This includes freedom from discrimination on the basis of race, sex, ability, sexuality or religion. Examples of these legislations are: Race Relations Act 1976: this prohibits discrimination on racial grounds. Racial grounds mean any of the following: "colour, race, nationality or ethnic or national origins". Disability Discrimination Act 1995: makes it unlawful to discriminate against people in respect of their disabilities. Sex Discrimination Act 1975: protect men and women from discrimination on the grounds of sex. The Act is mainly in relation to employment, training, education, harassment, the provision of goods and services, and the disposal of premises. Your organization will also have different policies and procedures that ensure individuals are not discriminated against. These might include: Confidentiality Any policy that relates to any form of discrimination Risk assessment Service users care plan/daily living needs

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K2.

How do you provide active support and promote the individuals rights, choices and well-being when supporting them in their daily living? You should ensure you respect the individuals preferences all the time and support them to be as independent as possible recognising and encouraging their achievements. For example this could be when you are supporting a service user with their personal care and they want to dress themselves you should allow them to do it even if it takes more time than it would with you doing it for them. I provide active support to individuals by always giving them a choice in everything I do. In circumstances where the individual will not be able to fully participate in all decisions about their day to day lives because they have a different level of understanding this could be someone with learning difficulties. In this situation you should ensure the individual has an advocate and the advocate is actively involved in decisions to make sure the individuals point of view is taken into consideration. Give a practical example of an individual you have supported them in their daily living to support your answer.

K 3.

What are the codes of practice and conduct, standards and guidance relevant to your own and the roles, responsibilities, accountability and duties of others when supporting individuals in their daily living?

This includes Mental Capacity Act (2005) Code of Practice The Care Standards which are provided by the Care Quality Commission General Social Care Codes of Practice (GSCC) Read about these legislations and standards and summarise your responsibilities and that of others. 1. As a social care worker, you must protect the rights and promote the interests of service users and carers. 2. As a social care worker, you must strive to establish and maintain the trust and confidence of service users and carers. 3. As a social care worker, you must promote the independence of service users while protecting them as far as possible from danger or harm. 4. As a social care worker, you must respect the rights of service users while seeking to ensure that their behaviour does not harm themselves or other people.
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K4 .

What are the current local, UK and European legislation, and organisational requirements, procedures and practices for accessing records recording, reporting, confidentiality and sharing information, including data protection Health, safety, assessing and managing risks associated with supporting individuals in their daily living? Supporting individuals in their own homes?

Before you can access records and information on individuals you work with you need to be aware of legislation and organisational procedures such as: Data Protection Act 1998 Access to medical records Act Human Rights Act 1998 Care Standards Act 2000 Confidentiality policy General Social Care Council (GSCC) Code of Practice You also need to know the procedures of health and safety and risk assessment, for example: Risk assessments should be in place and should be followed in assisting individuals in their daily living activities Regular updates on relevant training Following agreed procedures Using PPE ( Personal Protective Equipment) Examples of legislations involved in this are Health & Safety at Work Act 1974,Health & Safety First Aid Regulations 1981,Manual Handling Operations 1992 etc
K5.

Describe the types of activities you may need to do to support the individuals with whom you work in their daily living.

Examples of these activities are: Assisting a service user to prepare a meal Assist an individual with shopping Escort an individual to the bank and give them support to carry out their transactions Accompany an individual to church Support an individual to attend their GP appointments or any other appointments.

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K6.

Where do you go to access information that can inform your practice when supporting individuals in their daily living?

You should include: The local library Internet- Visit reliable web pages for example the NHS, Care Quality Commission etc Manager/colleagues can be able to share information with you. Attend training courses which can be arranged by talking to your manager. Reading the individuals risk assessments and care plans. Talking to the people who might know the individual better than you like previous carers, their family, care coordinator etc
K7.

What are the responsibilities and limits of your relationships with individuals when supporting them in their daily living?

The relationship between you and the individual should always be kept professional and you should not take advantage of them in any way. You should not allow the individuals to become very emotionally attached to you as this might be a problem if you then decide to leave the job hence you should not over step the boundaries given to you by your organisation; It is your responsibility to follow all the policies and procedures in your organisation when carrying out your duties respecting the individuals choices and not imposing anything on them. Give a practical example of how you have done this at work.
K8. Describe the methods that encourage individuals to use their strengths and potential to participate and to take as much control over their lives as possible.

This might include: Providing different aids for individual depending on their needs: o kitchen aids like plate guard, kettle pourer o bathroom aids like a raised toilet seat o dressing aids like sock aid and leg lifter o mobility aids o Reading and writing aids Involving the individual in every decision being made about their lives, consulting them and respecting their choices also allows them to take control of their lives.

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6___________________________________________________________________________ Some individuals are encouraged to do more by being verbally praised for trying. What are the risks, dangers and difficulties associated with different environments, equipment, materials and activities and in relation to specific individuals?

K9.

The risks will differ from individual to individual depending on their abilities and the activities being carried out. For example:Activity Cooking Risks/Dangers/Difficulties Cleaning Fire The individual burning themselves Food poisoning from improper cooking Chemical burns if protective clothing is not used Dangerous fumes being emitted if cleaning chemicals are mixed. Falls due to wet floors Individual getting lost if they are not accompanied The individual being run over by a car if they do not cross the road Electrocution from faulty equipment

Bathing Attending a day centre

Using any electrical equipment like Hoover, kettle, toaster, etc

K10.

What are the factors that can affect the behaviour, skills, abilities, development and the willingness of individuals to be involved in their own care and decisions about the assistance you should give to them?

These can include Hearing impairment

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K11.

Visual impairment Learning disabilities Physical disabilities (Cerebral Palsy, Motor-Neurone Disease, Parkinson's, Stroke etc.) Dementia Autism Mental issues - psychosis, depression
Describe the different health and social care conditions that affect the individuals with whom you are working.

You can cross reference to K10.

K12.
Describe potential key changes in the conditions and circumstances of individuals with whom you work and actions to take in these circumstances.

Some individuals conditions might improve and hence the amount of assistance they need to do some activities will need to be adjusted to suit the ability of the person. Some conditions might deteriorate causing the individuals to need more help. If you notice any change in the condition of the individual you need to report this to your manager. Bereavement If an individual loses someone close to them like a family member this might cause them some distress which might even lead them to be depressed. You will need to provide support for them or get them counselling if they require more help.

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NVQ Made Simple

Unit HSC221 Assist in the administration of medication.

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Elements within HSC 221 a. Prepare for the administration of medication to individuals b. Assist in and record the administration of medications
There are 17 knowledge requirements within this unit and 2 elements with performance criteria you will need to show that you are informed about them all and you understand the applications likewise. K1. Explain some of the current European and National legislation, national guidelines and local policies and protocols which affect your work practice in relation to assisting in the administration of medication

There is a variety of legislation that has an impact on the handling of medication in registered residential settings. They are: The Care Standards Act of 2000 The Regulation of Care (Scotland) Act 2001 The Health and Social Care Act 2001 The Childrens Act 1995 and 2001 The Human Rights Act 1998 Disability Discrimination Act 1995 The Data Protection Act 1998 The NHS Scotland Pharmaceutical Service (Regulations) 1995 The Consumer Protection Act 1987 The Medicines Act 1968 The Misuse of Drugs (Safe Custody) Regulations 1973 as amended by The Misuse of Drugs Regulations 2001 The Misuse of Drugs Act 1971 Control of Substances Hazardous to Health (COSHH) 2002 Hazardous Waste Regulations There should be information available on the relevant Standard on Medication in your organization. Find out where such information is stored, read and write a summary. K2. Explain your working understanding of your responsibilities and accountability in relation to the current European and National legislation, national guidelines and local policies and protocols.

Working in line with your organizations policies & procedures enable you to work in line with best practice and the law (legislation). There must be a policy at your work

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10___________________________________________________________________________ place for the receipt, recording, storage, handling, administration and disposal of medicines. Check your staff handbook on policies & procedures file depending on your care setting, there should be a list of procedures relating to administration of medication with regards to your job role. Make a list of this and explain. It might include policies such as: K3. Never give medicines if you are unsure about what you are doing. Always check the care plan to guide your actions etc. Ask for support from senior staff What is the importance of working within your own sphere of competence and seeking advice when faced with situations outside your sphere of competence?

It is unsafe to carry out activities that you are not trained to do or you dont feel capable of doing it. This can lead to harm and danger to the service user and to you. You could be liable to penalties for breaking the law. K4. Explain the importance of applying standard precautions and the potential consequences of poor practice. You need to state how and what you do at work to ensure your safety and the safety of others and what will happen if you dont do these things. Your list might include: How you deal with accidents such as spillage of medicines, needle stick injuries, handling of cytotoxic medicines. How you dispose excess medication. What equipments do you use at work to deal with risks? Do you use gloves, aprons, washing facilities, and spillage kits or sharps disposal containers? Giving a little summary will show your understanding. You might want to start by saying: At my workplace, I dont touch medication with my bare hands especially cytotoxic medicines. I make sure I wear gloves when applying creams and ointment to reduce the risk of cross contamination and potential harm to me..................... K5. Why should medication only be administered against the individuals Medication administration record and consistent with the prescribers advice? This is legal procedure making it easy to track records and information when it is required and also it must be consistent with the prescribers advice to avoid overdose or

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11___________________________________________________________________________ under dose. Other members of the care team would also be able to determine if medication has been administered or not to avoid overdose. K6. Who is responsible within your work setting for checking and confirming that the details and instructions on the medication label are correct for the service user and with the medication administration record sheet/protocol?

When you are required to work and assist with the administration of medication, who do you work alongside with? Is it the nurse in charge or matron in a home or the senior care worker appointed to administer medication? K7. What are the actions you should take if you disagree with the person leading the administration of medication?

If you disagree with the person leading the medication you should contact the pharmacist to clarify any confusing information or incomplete instruction. K8. Explain your understanding of the instructions for the use of medication of patient information leaflets and manufacturers instructions.

Information can be taken from the Product Information Leaflet (PIL) which must be supplied by the pharmacist for each medicine dispensed. This is written by the drug manufacturer and explains all about the medicine. If any information is unclear from the PIL, you need to speak to the pharmacist or dispensing doctor. The individual is also an important source of information about the medicines they take. It is good practice to keep all the PIL alongside the Medicine Administration Record (MAR) charts for reference purposes. K9. What are the different routes for the administration of medication?

Routes of administration. Orally medicine are taken via the mouth in the form of tablets, capsules, liquid or suspension. Sublingually medicine administered under the tongue Inhalation this is a route used by patients who have chronic respiratory problems such as asthma. Medicines are easily delivered to the lungs eg inhalers and nebules for use in a nebuliser. Intramuscular injection medicine is injected into large muscles in the body usually the leg or bottom. Intravenous injection medicine is injected directly into the veins where it can be absorbed rapidly into the blood. This is advantageous when a situation is life threatening.
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12___________________________________________________________________________ Subcutaneous injection medicine is administered directly under the skin, for example insulin. Rectally medicine administered into the rectum Vaginally - medicine administered into the vagina Topically medicine is applied to the outer surface of the body e.g. skin Transdermally introduced unto or into the skin which is worn e.g. a patch PEG Percutaneous Endoscopic Gastrostomy medicines are introduced via a PEG tube which has been inserted directly into the service users stomach.

K10. State the information which needs to be on the label of a medication and its significance. Medicine to be administered must always be labelled and the label should have: The name of the person to whom the medicine is to be administered The name and address of the person who supplies the medicine e.g. the pharmacy address The date of dispensing Directions for use The words keep out of the reach of children Any precautions or warnings relating to the use of the medicine Information you must know before using a drug. Route of administration Time of administration Any drug interaction Any special requirements Frequency of administration Any side effects Any cautions Correct dose to be given K11. List the various aids, which can be used to help individuals take their medication.

They are also referred to as medicine compliance devices to support service users with reduced strength and manual dexterity to access their medicine and also provide a visual aide memoir to remind them which medicine to take and when. There are two major types: Daily Dose Reminder (DDR) Monitored Dose Systems (MDS) Other examples are Medidose and Dosette

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13___________________________________________________________________________ K12. Explain your understanding of the importance of communication and different ways in which you can communicate. It is important that before you administer medication you communicate with the individual. This could be verbal or non verbal. You may choose to ask the individual to tell you their name in a polite manner rather than asking are you Mr A or Mrs B. In the case of non verbal communication which might be an individuals preferred method of communication you may need to show them the MAR chart which might include their photograph and they will be able to confirm their identity and show that they are ready to take their medication. It is important you support individuals by answering their questions and discussing their concerns, it is always helpful to avoid medical jargons as this can cause the individual to be confused. Also it is important that communication between yourself and the nurse or team leader or whoever you are assisting is effective to avoid misunderstanding and mistakes. What is the importance of identifying the individual for whom the medications are prescribed.

K13.

It is highly important that you establish the service users identity so that the right medication is administered to the correct service user; you can ask personal details such as name and date of birth where appropriate and check against the MAR sheet and name on wrist band if worn. In addition you can use the current photograph of the service user. It is dangerous if you administer medicine to the wrong person as this can lead to very adverse reactions or life threatening incidents. Why is it vital that you confirm the medication against the prescription/protocol with the person leading the administration before administering it?

K14.

It is very important that medication is not given in error therefore if an organization has a policy that you administer medication after it has been confirmed by a leading person it must be done that way to prevent omissions and mistakes. K15. What is the importance of correctly recording your activities, as required?

Every care staff is accountable for their actions at work; therefore records of your activities should be accurate and legibly as it can be used as evidence in a court case.

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K16.

Explain your understanding of the importance of keeping accurate and up to date records.

Use your understanding about completing records accurately in HSC21. Give practical reasons why your records should be up to date in relation to administration of medications. K17. What is the importance of immediately reporting any issues which are outside your own sphere of competence without delay to the relevant member of staff?

A good example is what to do when you make an error in administration of medication. Anyone can make a mistake but it is important you report the incident immediately to your manager to avoid any damage or deterioration to the health of the individual. Your workplace should have a policy in place of what to do when an error in administration has been made and why. Read and summarize. If you have administered medicine to an individual and they develop an adverse effect which you are not competent to handle you need to report following the procedures at your workplace.

Reflective Account
Reflective Account In order for your assessor to support you with gathering evidence to meet the evidence requirements for your NVQ your assessor needs to have an accurate description of your normal working role and the activities that you would normally undertake during a normal working shift. Your assessor may use the following activity to help them identify the option units that you will be most able to demonstrate your competence in, this will make your qualification easier for you to achieve. Your assessor will also be able to use the information you give in the activity to assist in planning how you can demonstrate your competence meeting the evidence requirements of the different units of your NVQ. It is important that whilst undertaking this activity you give as much detail as possible. It may help to pretend that you are describing your job role to someone who has never worked in Care before. You can also use this as evidence for your portfolio. Write a detailed account of your last working shift. Start at the time you started your shift to the time that you finished. Your account will be a record of events that actually happened. This must be reflected in your style of writing. The account is of what you did, this will need to be stated throughout your report.

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15___________________________________________________________________________ For example I did this and then I did that. It is NOT acceptable to write I would do this or that as this does not demonstrate you doing it. If possible explain why you took certain actions. For example I assisted Miss R to the toilet, prior to removing her soiled pad I put on an apron and disposable gloves to protect myself from possible cross infection, and to provide dignity for Miss R.. By doing this you will provide evidence that you have knowledge and understanding about why you undertook the activities in the method that you did. Throughout your account you must maintain confidentiality of information. You must not refer to your clients by their actual name, it is acceptable to use initials such as Mrs R, Miss A or Mr K etc. Remember the more information that you give the easier it will be for your assessor to help you plan how you will meet the evidence requirements for your award. It may help to make notes throughout the shift of all the different activities that you undertook. The following points will help you construct your account: 1. The different activities you undertook. This should include the performance criteria for HSC221a and 221b. See below There are many other activities that you might have been involved in which you should include in your account. 2. The way in which you carried out the activities. This might include: How you communicated with clients and others such as colleagues, relatives and other professionals. How you treated people as individuals and showed them respect and dignity. How you maintained a professional relationship with the different individuals. Did you have to deal with any conflicts, distress or challenging behaviour? How you worked as a team. How you monitored and maintained health and safety during the different work activities. What information you passed on. How. What records you made.

Below is an example of a carer supporting one client throughout her work. Note the amount of detail that the carer has given, and how she has explained why she did certain actions. This account has also been fully referenced against the standards which you will also need to do. The main unit referenced in the reflective account is HSC221 Administration of medication although it can be cross referenced to other units to ensure you are working holistically that is; working on more than one unit at a time as the case may give opportunity to do so. This should be used as a guide only, as your responsibilities at work may differ from what has been written.
See reflective account sample below:

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16___________________________________________________________________________ Candidate Evidence Recording Sheet NVQ Title: Health and Social Care Level 2 NVQ Unit: HSC221 Evidence Ref. No: Unit Evidence: Candidate Name: NVQ Made Simple
Use this form to record details of activities (tick as appropriate)

Observed by your assessor Seen by a witness

self reflective accounts Project/Assignment

Work Product APL

Links to: Unit Eleme No nt No

Performance Evidence on: P.C. No Date of Activity: 00-00-0000

I work in a nursing home and part of my responsibility after meal time is to assist the nurse in charge with medication. One morning shift I worked on a floor with 12 residents. I supported them to get washed and dressed and move to the dining table for breakfast. There is a particular lady I always assist lastly according to her choice and preference as she doesnt like being woken up from bed too early. This morning I supported her with personal care and I tidied her room by putting back things in its rightful place and then I washed my hands. I later asked the service user whether she is ready for her breakfast but she said No, I explained to her that it was time to take her medication and she agreed to take it. Since she said that she is not ready for breakfast, I offered her a cup of tea or juice as alternative and She agreed to have the cup of tea. I asked if she want to stay in her room or go to the lounge and she chose to go to the lounge. I took her to the lounge with the wheelchair, and then wash my hands before making her a cup of tea for her. Afterwards, I went to confirm with the nurse in charge the time for administration and I was asked to prepare for the administration of medication. I collected

Links to Scop KS e

221

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the key to the medication room from the nurse and went to the medication room; I first recorded the temperature of medication room and then washed my hands. I checked for the medication pots and dried them, then checked for the records of the service users on the floor I was assigned to and made sure the medication is not yet being administered and medication administration is up to date. The medication trolley already housed most of the medication I just put the records on the trolley and wheeled out to the lounge where I was to assist the nurse in charge. I made sure I locked the medication room with the key. Throughout this period I worked alongside the nurse in charge. I read the MAR sheet to make sure that the service user name, date of birth, name of medication, dosage and time is corresponding with the medication to be given. I read the leaflet for side effects and then put the medicine in the pot using the non touch technique as I took the tablets out of the blister packs, and I dotted the MAR sheet to indicate that Ive taken out some medicine for a service user. To ensure I gave the medication to correct service user I checked the picture of the service user on the MAR sheet and politely called their name and confirmed with the nurse who the medication is meant for. One of the service users medication dosage stated 5mls and after I had handed the graduated medicine pot to the service user he drank it and asked for more saying that he was allowed to have more when he wanted to I reported this to the nurse in charge and I was told that giving additional medicine beyond the prescribed dosage was not possible, therefore I had to explain to the service user that his health and safety needed to be maintained by taking only prescribed dose. I assisted the nurse to administer medication to other service users making sure I observed them take it and swallow it before I moved to the next service user to ensure the medication was not passed on. After the medication round, I ensured all MAR sheets were updated correctly and I recorded how one of the service user refused medication and I disposed the medication into the correct packet according to the instruction of the nurse in charge after she had tried to encourage the service user to have them but he refused. I returned all records along with the medicine trolley to the medication store room. I made sure I did not leave any service users records carelessly to maintain confidentiality of information that is I ensured inappropriate persons like the cleaning staff or visitors did not have access to service users

221

221 221

a b

4 2

HSC221 KS 5

221

HSC221 KS 6 HSC221 KS 3

221

221 221

b b

5 6

221 221

b b

4 7,8

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18___________________________________________________________________________ record and I made sure the medication trolley was not left without supervision at all times. Candidate signature:............................................................................ Date:.................. Assessor signature:.. Date:.............. Internal Verifier signature and date (if Sampled):... Date:...........

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