Safeguarding, Ethical and Legal Issues Flashcards
What is an advanced care plan?
Record of your treatment and care wishes
Must be in accordance with the persons best interests, taking into account the persons previous wishes and feelings via:
- an advanced statement
- views of legal proxy
- verbal statements before capacity was lost
What is a power of attorney?
Health + Welfare or Property + Financial
An appointed person to make decisions on their behalf when they lose capacity
Must be registered with the Office of the Public Guardian before coming into effect
What is an Independent Mental Capacity Advocate?
Individual that lacks an effective next of kin and have no other friends or relations to speak on their behalf - appointed independent advocate
Required for serious medial decisions and when a change of residence is contemplated
Outline Deprivation of Liberty Safeguards
Pts who lack capacity should be deprived of their liberty when it is in their best interest (in the lest restrictive way)
- Meds against a persons will
- Staff having control over care/movements for an extended period of time
- Staff making decisions about Ix, Mx and visitors
Describe the signs of abuse in older/vulnerable patients
- becoming quiet and withdrawn
- being aggressive or angry for no obvious reason
- looking unkempt, dirty or thinner than usual
- sudden changes in their character, such as appearing helpless, depressed or tearful
- physical signs – such as bruises, wounds, fractures or other untreated injuries
- the same injuries happening more than once
- not wanting to be left by themselves, or alone with particular people
- being unusually lighthearted and insisting there’s nothing wrong
Outline how to raise safeguarding concerns
Local council, safeguarding team duty
Safeguarding in an in-patient setting = Trust Safeguarding Team (e-irf)
Outside working hours = emergency duty team
Inform police if criminal
What is the mental capacity act?
The Mental Capacity Act 2005 (MCA)
Provides a comprehensive framework for decision making on behalf of adults aged 16 and over who are unable to make decisions for themselves, i.e. they lack capacity
What is the role of the Court of Protection
Responsible for determining disputes as to the registration of enduring powers of attorney, and Lasting Powers of Attorney, appointing new trustees, appointing deputies to manage the affairs of persons who do not have the mental capacity to make the relevant decisions
It has jurisdiction over the property, financial affairs and personal welfare of people who lack mental capacity to make decisions for themselves
It has the power to decide if a person lacks capacity to make decisions for themselves, and then to decide what actions to take in the person’s best interests.
Outline decisions surrounding Do not attempt cardiopulmonary resuscitation
If the cause of arrest is not CVS/resp and is reversible then CPR should be performed while the causes is being reversed
Discussions to be had
- Is CPR likely to be successful?
- Does the patient want CPR?
- Is CPR in the patients best interest?
What is an advanced decision to refuse treatment?
Legally binding document that the person has drawn up (when they had capacity to make decisions) and in which they have stipulated certain treatments that they would not wish to receive, and the circumstances in which those decisions would apply.
Where a properly drawn-up ADRT refuses CPR (despite acknowledging that their life would be at risk) a healthcare professional who attempts CPR on that person in full knowledge of the valid ADRT would be at risk of a charge of battery.
What is the concept of NHS ‘Continuing Healthcare’?
Package of care for people who are assessed as having significant ongoing healthcare needs. It is arranged and funded by the NHS.
If you receive care in your own home the NHS covers the cost of the support you need from health professionals and the cost of personal care which can include help with washing and getting dressed.
If you receive NHS continuing healthcare in a care home the NHS pays your care home fees.
Outline the Discharge to Assess (DtA) process
Where people who are clinically optimised and do not require an acute hospital bed, but may still require care services are provided with short term, funded support to be discharged to their own home (where appropriate) or another community setting.
Assessment for longer-term care and support needs is then undertaken in the most appropriate setting and at the right time for the person.
