💡💡✅Important Questions Bristol Flashcards
(37 cards)
What did the care quality commission do to check the quality of care provided at Winterbourne view?
- We asked 10 people who lived at Winterbourne View for their views.
- We watched to see how staff treated people
- We read some records and notes about people who lived there
- We asked staff for their views and talked to the managers.
What did the care quality commission find out about winterbourne view?
- The managers did not tell us about important things that happened at the service, like people getting injured/ when some people left the house without permission
- systems used to check the quality of care were not good enough
- The managers were not able to deal with any problems that could affect the health and safety of people who used the service. (included people being abused)
- They did not reply to some of the complaints made by people who used the service. (included complaints about abuse)
- When managers looked into the poor behaviour of staff, they did not do this carefully enough to keep people safe.
- Staff held people down in a way that is not legal
- Service did not manage staff properly/give them the right sort of training/check they were qualified
What actions did the care quality commission take against the service at Winterbourne View to make things better for people
- We stopped any more people coming to stay at the service
- We worked with the council and the NHS to make sure that people were kept safe until they went to live in a new place
- Because we were still so concerned about what we found, we stopped the owner from running any more services at Winterbourne View.
What was winterbourne view?
Winterbourne View was an independent provider of health care and support for adults who have learning disabilities and other needs. They may also have been kept in care by a law called the Mental Health Act.
Name the act relevant to social care
The Health and Social Care Act 2008 established the Care Quality Commission as the regulator of all health and adult social care services in England
Duties of a candor (honest professional within a healthcare setting)
When a service is meeting the duty of candour patients should expect:
1) A culture within the service that is open and honest at all levels.
2) To be told in a timely manner when certain safety incidents have happened.
3) To receive a written and truthful account of the incident and an explanation about any enquiries and investigations that the service will make.
4) To receive an apology in writing.
5) Reasonable support if they were directly affected by the incident.
Fact about charges of staff in winterbourne view carehome
9 support workers and 2 nurses were admitted 38 charges of neglect/ill treatment of people with severe learning difficulties
Nurse verbally abuses a mentally handicapped resident, doesn’t let her go to toilet until she soils herself, what are the ethical issues of this
- Patient autonomy -patients choice what to do with her body
- Capacity -as she’s handicapped she may not be able to understand the magnitude of the situation and :: goes unreported, May happen to other residents.
- Beneficence -not acting in best interests of patient, emotional abuse, physical abuse, embarrassment, holistic approach. As she’s mentally handicapped she’s more vulnerable to bullying.
- Non Maleficence -clearly causing harm to the patient, goes against duty signed in Hippocratic oath, clear lack of judgement
- Justice -treating all people equally despite handicap, clearly targeting those vulnerable
You witness member of staff verbally abuse someone with learning difficulties by not giving them their evening meal what do you do?
- Quickly Raise attention of the situation to another member of staff if at all possible (they have more experience and know what aid the patient requires)
- Ask the other member of staff their opinion and clearly state your belief that they should be prohibited from seeing another patient until an investigation is carried out -(send her home and get emergency cover if needed)
- Document everything that you as a volunteer have witnessed and report this to the appropriate senior colleague
- Ensure that the nurse in question is okay, act compassionately to prevent further confrontation and offer support if needed.
- Check that the complaint has been acted on/taken seriously, if not report to the quality of care commission for them to audit
- If possible speak to the handicapped individual about their treatment, offer suitable support if possible as a volunteer. If the patient isn’t competent ask members of staff to inform patients family of issue/solutions
- Example: winterbourne view care-home
Somebody has broken their leg which departments are involved after being admitted to A&E?
- Radiographers
- Orthopaedics
- Physical therapist
- Occupational therapist
- Nutritionist
- Surgical team (if required)
(Tibia thicker than fibular)
What are the qualities of a doctor?
- Empathy/compassion (Velindre oncology tertiary centre)
- Good communication (with patients with fellow doctors, (stroke ward)
- Resilience (deal with uncertainty, optimistic, patience) (peer mentoring)
- Respect patients (confidentiality, active listener, Beneficence) (Monday Club)
- Interest in learning (Wilson F2 doctor in llandough)
Describe how you’d obtain consent from a deaf individual
- Visual information (symbols/pictures/diagrams)
- Develop consent forms/ information packs that’s are clear and readable at a low level)
- Provide real situations and examples to explain abstract concepts
- Operationalise key terms (anything scientific/unfamiliar)
- Videotapes that show the process or performance of treatment
- Make sign language available (either whilst doctor is speaking/ video is playing for those who prefer this)
- Use interpreters (priority places in finding the most direct communication)
- Must be delivered by suitably qualified/experienced staff
How to assess capacity of deaf patient
- As soon as patient arrives/ before admission staff check the patient has nah aids of equipment they need
- Staff introduce themselves
- Staff ask questions with interpreter present (if found/preferred by patient) to assess capacity
- If they have career/social worker communicate with them about capacity (As long as inferred consent is given)
What skills do you need to work in a team?
Link to H&W week
Good communication
active listening/reasoning skills
Accountability/responsibility
Organisational skills
Conflict resolution skills
Reflection skills
Characteristic that would make it hard to become a doctor
Too high expectations of myself- how I’ve improved from this
A boy is being bullied in school and posts on social media “what is the point of going on” what do you do?
- recognise bullying (lack attendance, post big clue, isolation etc)
- Reach out to the child, be a friend/crutch to lean on, let them know it won’t last forever/tell them the bullying isn’t their fault (and their a likeable person)/offer your immediate help to sort it out (go over their house if accessible, meet for coffee etc).
- If your not close to the child see if he has any close friends, if not reach out yourself
- If you can’t personally reach out call the Samaritans on 116 123 and they will anonymously reach out to them
- Immediate danger call 999
- Encourage them to speak (call Samaritans themselves) 116 123
- Talk to the school report the bullying, encourage them to talk to the school
- Report/record every incident of bullying report to school if it doesn’t stop
- Communicate with bullies, tell them the seriousness of the impact that they’re having
- If it still continues contact educational department/ seek legal advice/ tell police
Who could you tell about the bullying??
- Councillor
- Head of pastoral care in school
- Family of the child being bullied
- Encourage them to tell Samaritans/childline
Role play: giving advice to an alcoholic who’s grieving
- Introduce myself calmly, with reassuring ora
- Small talk
- Ask them how long their alcoholism has affected them (should see correlation with mothers death)
- Tell them that alcohol is often part of the greiveing process and that their not alone
- Explain to the different modes of treatment accessible to them for the alcoholism (medications, counselling, rehabilitation, AA etc)
- Alcoholism will decrease with better management of grieving, offer him a councillor dedicated to listen to his needs, actively listen to him, silence is okay.
How do you deal with a situation that you’ve made a mistake in patient care?
- Recognise error and own up to it (integrity and honesty)
- Take immediate steps to correct it if possible
- Involve the right people to advise and help out (teamwork and communication)
- Communication to patients is vital, be honest about what has happened, APOLOGISE, and discuss with them ideas on how to further manage their care, where to go next, they can get a second opinion if faith in doctor is decreased etc etc
- Analyse situation and draw lessons from it (willingness to improve)
- Apply lessons and ensure others don’t make the same mistakes
How should we deal with staff who make mistakes?
Matters more about the action after the mistake is made.
If they recognise the mistake immediately, follow procedures and show remorse then the doctor should be cared for
Is it an accident or negligence/how often does mistake occur/was it anticipate e.g in complicated surgery or simple task gone wrong
Does the patient (plaintiff want to take legal action) if so then hospital pays out
if gross negligence is detected doctor removed if liscence
Most mistake corrected immediately however and doctor remains working, just maybe for a different patient/hospital
Doctor learns from mistakes
How to deal with medical priorities questions
- Unwell patients always come first (clinical need/ Nye Bevan)
- Think of physical effects of surgery
- Think of social effects of surgery
What are the roles of a leader
1- delegate tasks 2- clear communication 3- involve the opinions of all 4- resolve conflict 5- responsibility and accountability 6- organisational/keep members informed
How do you deal with conflict within a team?
- Recognise conflict and know that it’s expected
- Set ground rules at first meeting to address preocedure when there’s conflict
- Stop conflict when it happens before it grows (discuss as a team what’s best) but don’t fall into suppressing people’s views
- Get the whole story (talk to each party if needed)
- Make compromise, propose alternative but understand that you can’t change their opinion but help them accept the opinion by telling pros and cons of both ideas
What observations can you infer from a picture?
Gender of person Age of person Ethnicity of person Abnormalities in photo Sign and date notes
