1. Introduction

Staff across all organisations must treat adults with care and support needs, and their carers, friends and family with dignity, compassion and respect at all times and in all circumstance.

Staff must adopt a culture of care that respects the privacy, dignity, culture and individuality of all patients under its care and staff (see also Equality, Diversity and Human Rights in a Safeguarding Context).

2. Principles

All staff must:

  • recognise the diversity, values and human rights of adults;
  • uphold and maintain their privacy, dignity and independence;
  • provide care, support and treatment in a way that ensures their dignity, and treats them with compassion and respect at all times;
  • ensure that they have privacy when they want it, treating them as equals;
  • provide any support they might need to be autonomous, independent and involved in their community;
  • help adults maintain relationships that are important to them
  • put adults at the centre of their care and support by enabling them to make decisions (see Making Safeguarding Personal chapter);
  • all communication with adults and their families must be respectful and compassionate. This includes using or facilitating the most suitable means of communication and respecting their right to engage or not to engage in communication;
  • provide information that supports them in the safeguarding process, or others acting on their behalf, to make decisions;
  • support adults, or others acting on their behalf, to understand the care and support provided, including risk and benefits and their rights to make decisions;
  • staff must make sure that they provide appropriate care and support that meets people’s needs, but this does not mean that care and support should be given if it would be against the consent of the person (see the chapters on Consent in Relation to Safeguarding and Mental Capacity);
  • address them in the way they prefer, including their favoured name;
  • have regard for the protected characteristics as defined in the Equality Act 2010, that is: age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex; sexual orientation (see also Equality, Diversity and Human Rights in a Safeguarding Context).

3. Personalised Care and Support through Involvement

Adults should be involved in and receive care and support that respects their right to make or influence decisions. Staff should:

  • explain and discuss their care and support options with them in a way that makes sense to them;
  • respect their right to take informed risks, while balancing the need for preference and choice with safety and effectiveness (see Managing Risk);
  • ensure that things that are important to the adult in relation to their care and support are established as part of their assessment, development and review of their plans;
  • promote and respect their autonomy, privacy, dignity, compassion, independence and human rights at all times by:
    • placing their needs, wishes, preferences and decisions at the centre of assessment, planning and delivery of care and support;
      • respect their personal preferences, lifestyle and care choices;
      • when providing intimate or personal care, the organisation must make every reasonable effort to make sure that they respect the preferences of individuals in relation to who delivers their care and treatment, such as requesting staff of a specified gender;
    • have clear procedures followed in practice, monitored and reviewed that ensure staff understand the concepts of privacy, dignity, independence and human rights and how they should be applied;
    • ensuring that the need to maintain confidentiality or disclose information is taken account in the assessment of the individual circumstances (see South Tyneside Multi Agency Information Sharing Agreement);
    • actively listening to and involving adults, or others acting on their behalf, in decision making and ensuring there are clear records that evidence the decisions made and methods in which the decision was achieved;
    • provide information to help them, or others acting on their behalf, to understand their care and support, including the risks and benefits, and their rights to make decisions;
    • make adults aware of independent advocacy services wherever they are available, and cooperate with independent advocacy services (see Independent Advocacy);
    • know how to raise a concern or complaint about the organisation, and how it will be dealt with (see Whistleblowing).

4. Managing Risk through Effective Procedures about Involvement

Procedures must ensure that:

  • care and support options, and the risks and benefits of those options, are explained to the adult / their representative;
  • choices and preference of the adult are expressed by them or others acting on their behalf;
  • the choices of adults are respected and accommodated unless:
    • the choice places other people at risk of harm or injury;
    • it would not be reasonable to expect the service to have the resources needed to achieve the choice;
    • if to meet choice is not within the stated aims, objectives and purpose of the service provided;
    • the adult does not have capacity to make that decision or is subject to a legal restriction that prohibits them making a choice (see Mental Capacity and Consent in Relation to Safeguarding);
  • individualised assessments and plans of care and support are based on the adult’s needs, choices and preferences;
  • any reasonable adjustments are made so that the adult is enabled to be involved in decision making.
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