Unit 2: Equality, Diversity and Rights in Health and Social Care

Assessment Criteria: Explain the Concept of Equality, Diversity and Rights in Relation to Health and Social Care. Describe Discriminatory Practise in Health and Social Care. Describe the Potential Effects of Discriminatory Practice on Those Who Use Health or Social Care Services. Assess the Effects on Those Using the Service of Three Discriminatory Practices in Health and Social Care Settings.
Equality: -
The term equality according to Dictionary.com (2015) “Is the state or quality of being equal; correspondence in quantity, degree, value, rank and or ability” however I believe that this definition can establish misconception on the view of an individual, and so the more realistic concept behind ‘Equality’ in regards to the health and social industry; is for all individuals to be provided with equal opportunities to access of the concerning services, and for these users to be treated fairly (not equally) accordingly to the approaches used to meet their individual needs.
Diversity: -
Is a termed used to describe the promotion and celebrating of differences which an individual may have on the aspects of your own identity as well as others.
Rights: -
"They are the legal entitlements which we are all privileged to own, with the aim of allowing equal opportunities for all citizens in certain aspects of an individuals' life. There are a number of rights entitled under the enforcement of The Human Rights Act. 2000 : The right to life, Freedom from Subjection to torture and degrading acts; Education and to not be subjected to any form of discrimination in the respects of all entitlement and personal freedoms i.e. freedom of speech. There are many more rights which we all legally own and need to be aware of, as well as demonstrating respect for these principles" (Lawrence, Stretch and Whithouse, 2010).
In the setting of an elderly care home for instance; equality would be implemented into all practices of different personnel with the aim of; ensuring a high quality of care and service is received by each resident, and attempting to meet their own individual needs. The residential sector of social care is a service open to the elderly when they struggle to continue living in their own homes, whilst maintaining their health or a long-term condition they may be finding progressively challenging to underline and treat. The personnel working under this sector will provide the practise of personal and medicinal care, to arrange for outside health visits when necessary (District Nurse, a residents own registered General Practitioner/GP) but these are preformed whilst still promoting and preserving each of the service users own independence as much as it is realistically possible. Discrimination against a resident or member(s) of staff will be called out upon to discourage the continuance of this behaviour, and prevent the influence of this practise in the environment of this care setting. Recognizing a residents or colleagues own differences in comparison to the other surrounding individuals and yourself. This recognition will need to be acknowledge in a positive manner, in the consequence of respecting, valuing and promoting these differences, to avoid creating barriers for the delivering of an effective quality of care for the service users, and building professional relationships with other personnel you will work alongside with and in the dynamics of group work.
There are many socially and culturally enriching benefits of diversity for services available in the Health and Social Care industry, which will overall prevent the practices of discrimination by exposing individuals to the aspects of another ethnic minorities' social and cultural differences. Traditions in the issue of food and dietary requirements will challenge the capabilities of personnel in a residential care home to respect, understand and comply with the principles of these food cultural needs. Residents' following a religion which condemns the intake of alcohol in any shape and form, will need to be respected by ensuring that all food content is alcohol free, or there are alternative meals available to accommodate the dietary and religious needs of that service user. This will on the perspective of the resident demonstrate acceptance of their diversity, and rights to express these cultural needs and share the values they hold freely, without the concern of being subjected to discrimination by all members of staff and other service users. Training in the promotion of equality, diversity and rights practises has allowed professionals of the Health and Social Care industry, to identify the forms of discrimination that all individuals on their working premises may befall victim to, and confront these issues in a professional manner to prevent such future occurrence.
"Individuals can be exposed to diverse cultures in the form of expressive arts i.e...e. Film productions, Music, Theatrical performance (Pantomimes) and contemporary expressions with drawings and paints. Can all help to build an understanding for these difference as well as acceptance, as fear can be associated with many aspects of diversity which are unfamiliar to our own differences, and so the discrimination can be result of an individuals defence mechanism to avoid confrontation with this irrational fear"(Lawrence, Stretch and Whithouse, 2010).
Tolerance can be learned through association with individuals of a different ethnic minority to us, as they can provide an insight into the views, values and beliefs which may differ from ours, and to attempt to understand why an individual may hold these personal aspects that differ to yours. This is a vital experience to have, as there will be incidents where we will be working with service which are less favorable to do so, being mature and professional is the correct approach to tackleing this issue, and it condemn the of practices of discrimination in health and or social care settings. Tolerance allows the personnel to disagree with these aspects of personal diversity in a professional manner, whilst they are still respecting their choices to uphold and freely express these views, values and beliefs.
"Care value base state the princes of good practise which describes the behaviour and attitudes that health and social staff should demonstrate whilst they are performing as professionals of this industry. The seven principles of the care base values highlight the key concepts of: Safety, Choice, Trust, Access, Honesty and Openness; Inclusivity, Confidentiality, Participation and Respect and the expectations of these professionals: * The Promotion of Anti-Discriminatory Practices * Dignity, Independence and Safety * Relationships with both parties and effective Communication * Recognition, Acceptance and Respect of Their Clients' and Colleagues' Differences in the Aspects of Their Personal Identity, Beliefs and Values * Safeguarding Against All Forms of Abuse and Discrimination * The Provision of Each Service Users' Personalized Care * The Maintenance of Confidentiality" (Lawrence, Stretch and Whithouse, 2010).
The elimination and prevention of discriminatory practices can be implemented into health and social care settings through staff training on Equality and Diversity, which would ensure that all service users receive fair treatment and equal opportunities from the service they are using, and the employees representing the promotion of their rights to these principles, and the condemning of discriminatory practices if such incidents are experienced. Training will ensure that all staff are up to date on all polices and procedures regarded by legislation, relevant to implementation of equality, diversity and rights into the practices of all working health and social care professionals.
Courses, (E-Learning) In House Training

Internet

Distance Learning

Opportunities to Provide Training and Development
Mentoring

Journals & Magazines
Telelvision
Work Shadowing (Work Experience)

Discrimination: - "The act of treating an individual less favorably than others, due to a particular characteristic trait they have i.e.. disability" (Disability Law Service, 2015). These are the Characteristics which can be the bases of discriminatory acts, against that individual or a particular group of service users: * Age * Cognitive Abilities * Culture * Disability * Family Status * Gender * Health Status * Sexual Orientation * Social Class

There are several behaviours which are deemed to be practices of discrimination which discriminate against both health and social care colleagues and the service users of the setting:
Infringement of Rights: -
"This would include the restricting of allowing service user express their differences without the feeling of being undervalued for these aspects of identity, they may be isolated from activities and discussions with other residents in the setting of an elderly care home, leading to possible effects on their own health and wellbeing" (Lawrence, Stretch and Whithouse, 2010). A resident can have opportunities restricted by carers in the instance of participating in activities, if the activities are not made available, or the carer ignores the wishes of the resident to take part. This would be an example of disrespecting the service users right of having their choices taken into account.
Abuse of Power : -
There are two type of discrimination; 'Covert' is the type of discrimination which is preformed secretly against individuals and is not as obvious and easy for others to pinpoint, so if the accused is call upon about possible discriminatory practises they have preformed against their colleagues or service users, it would be difficult to provide solid evidence on these accusations. 'Overt' is a more open form of discrimination which is easier to identify and quickly take necessary action against, to prevent further practices being implemented by staff or even service users. * Covert Discrimination - through the authority and influence a health and social care professional has, would be taking advantage of their trusted and well respected position to treat all clients in a similar manner. Intentionally making up excuses to avoid taking a resident with dementia to the toilet would be an instance of covertly abusing their power over the client, as the carer may take advantage of the residents' cognitive ability to remember what they requested from the professional, and to avoid being called up about the possibility of them practicing such acts of discrimination. * Overt Discrimination - This is the more open approach to practicing acts of discrimination against the users of a service. A general practioner (GP) could refuse to provide a young woman in her adolescents; a referral to abortion clinics due to the irrational beliefs they hold against teenage pregnancies. Which can lead to health issues if treatment is not made available i.e.. Postnatal Depression.
Abuse: - "Handling residents in a rough manner can entail a range of health complications i.e. Fractures, Dislocations and even psychological distress for the victim. Such incidents can occur due to high pressures placed on the settings personnel to continue meeting the individual needs of each service user in the preferred approaches, which can cause stress and frustration especially when there are staff shortages. A lack of support, staff supervision and or training can all lead to the occurence of such discriminatory practices" (Lawrence, Stretch and Whithouse, 2010).
Bullying: - The intention to intimidate and offend an individual using physical, verbal and written approaches. Ridiculing a resident who requires additional needs for their learning difficulties, by describing them as 'Stupid' and 'idiotic' would encourage the violent behaviours which are associated with mental health, and place the resident in a state of distress.

Stereotyping: -
"stereotyping is the act of categorizing a group of individuals, based on the beliefs they hold in regards to the characteristic traits believed to be associated with the individual fitting into that negative stereotype" (Urban Dictionary, 2015). In the health and social care industry assumptions made on needs and the care of a patients can lead to the individuals being ignored, as the staff are certain that these aspects of their clients remain the same and there is no need for them to check with others to make certain.
Labeling: -
Labeling is a term used to describe: A form of discrimination to label a service user with characteristics and their negative associations i.e.. A GP assumes that their client is gothic due to their choice of fashion, and so believe that they are dark minded and depressed.
Prejudice: -
The act of Prejudice discrimination can be defined as "Preconceived opinion that is not based on reason or actual experience" (Oxford Dictionaries, 2015). The origins of such practices are believed to be 'fear of the unknown' or differences which they do not understand, as they have never been exposed to such characteristics.
Empowerment: - Allowing an individual to take authority over something with a suitable amount of guidance which will also be depend on how much confidence they have in ones own capabilities.
Vulnerability: - A state of being susceptible to the exposure of harm; both emotionally and physically from others with the intent to do so.
The practices of discrimination will inflict a range of negative effects on the service user or the colleague being subjected to such practices (The instance of a class was used to show how all the effects can interlink with each other):
Marginalization: - An individual or group being marginalized is the act of segregating them from the main groups of society, which would include the action of excluding and isolating that individual or group as they do not fit the ideal aspects of the main group i.e.. A class of children with a majority following the religion of Christianity, and small percentage of children who are Muslim, may create an opportunity for these small group of children to be marginalized, during an activity which solely involves the religion of Christianity, as the teacher believes that the children following Islam will not be interested in Christianity.
Restricted opportunities: - This can interlink with the principles of marginalization as the small group of islamic children, will be restricted of their choices to participate in the activities, and their rights to an education as they will not be experiencing the same intellectual stimulation as the children of a Christianity background.
Dis-empowered: - The children of that marginalized group can be dis-empowered of their chances to fight the discrimination they are experiencing, and so the influential power of the social care professional will make the child feel devalued for the freedom of choice, isolated and even depressed.
Low self esteem/Loss of self-identity: - The children may feel vulnerable towards the possibilities of experiencing further more acts of discrimination both from the tutor and their class mates. They may doubt the worth of their own diversity and self-identity which are all the negative associates of low self-esteem.
"An IVF clinic are refusing to offer fertility services to a lesbian couple because they are not heterosexual" would be an overt approach of discrimination against the sexual orientation of the clients referred to this particular service. Refusing to provide health care for the couple under the circumstance of their sexuality is a form of discrimination, as the opportunity for them to have their own children is being restricted showing inequality to other heterosexual couples. This may make the couple feel dis-empowered as the misuse of the organizations authority, can influence the initial access which the couple have to the clinic, and the act of discrimination being experienced by them may be difficult to prove; as there may not be solid evidence of such incidents taking place. Feeling ashamed of their sexuality and identities, questioning their rights to be parents and experiencing a frame of vulnerability due to their orientation of sexuality and low-self esteem. This questioning of their rights as parents may lead to the couple evading the opportunity all together, and they may decide to not have IVF, or attempt to access other fertility treatments due the unpleasant experiences they have already gone through when attempting to use the first IVF clinic.
"A resident suffering with the early stages of dementia and challenging behaviour is refusing to have assistance whilst bathing, and so two members of staff decide to move, handle and restrain the service user roughly by her hands within the bath, as one other assistant is washing the resident and applying alot of pressure to the client's skin as it is scrubbed. The resident continues to struggle and shouts, screams and curses at the staff to indicate that she is in pain and they are hurting her, these pleads however are ignored, and the staff giggle and shout back 'Stop it! The More You Struggle, The More we'll restrain and keep you in the bath for' ". This sort of attitude, behaviour and performance being demonstrated by the personnel involved in the incident, is identified as engagement in abusive formats of discriminatory practices and Bullying with the intent of intimidating, ridiculing and subjecting the resident to degrading experiences such as the abusive situation that has occured. It appears to be discrimination on the grounds of cognitive ability/impairment, as the staff consider the client an easy target due to their dementia, and history of challenging behaviour, and as a direct result of this incident the staff may have disempowered the client, which can lead them in a state of depression, a loss of confidence in the settings staff and their abilities to provide an outstanding quality of care, and respect the wishes for the client to not participate in activities until they are ready to. The development of Low Self-esteem can result in such incidents, especially as the resident who has been subjected to such discriminatory practices, is considered to be a vulnerable due to the chronic condition they are already suffering with. The staff had no intent of releasing the resident from their restraint, and used the reactions being demonstrated by the distressed client, as a chance to mock, ridicule and infringe the rights to freedom from torture and degrading treatment. The choices of the client were disregarded and not taken into account, and their personal space and privacy was invaded and restricted by the staff who continued to handle the issue of assisted bathing without delicacy and consideration for the embarrassment that could've been experienced by the resident. I believe that on the basis of vulnerability in cognitive impairment the staff used this as an opportunity to take advantage of the client, as service users can be deemed too cognitively impaired to make sense of what is rational, and so others may ignore and discount the allegations of abuse as irrational thoughts and hallucinations which the client believes they have experienced, but are believed by others to be the nature of their dementia. This in itself would also disempower the resident, as entitlements to freedom of speech are discounted, which would lead to feelings of worthlessness and vulnerability. Low Self-esteem establishes negatively reinforced emotions i.e.. depression and thought patterns associated with their own Self-Identity, i.e.. the resident may devalue and view themselves as incapable, stupid and helpless.
The physical trauma which is inflicted can lead to anxiety, and an occurence of challenging behaviour demonstrated by the service users, as frustrations can develop due to them feeling helpless and powerless in preventing such abuse being experienced. These negative thoughts and emotions can be expressed in an aggressive and abusive manner, both physically and verbally by the service user on individuals in a position of power, but will not consider acting out discriminatory practices like the personnel who engaged in abusive formats.
"During his work experience at a residential care home with several Bengali residents, Nathan is told by his mentor that the menu is only in English, as they don't have a person who can write the menu in Bengali. The residents who are unable to read English are unable to make choices from the menu and just get what they are given" (Lawrence, Stretch and Whitehouse, 2010). This case can be considered as an example of discrimination based on the grounds of racial differences, as the group of Bengali residents, are having their opportunities and rights for choice restricted by the staff as they are 'Get what they are given' unlike the other ethnic minorities that are residing within the care setting. This appears to be discriminating on the grounds of race, and the clients who are experiencing such practices may start to develop a Low Self-esteem and Self-Confidence or maintain it at a low level if it was originally. Self-esteem will effect how much the Bengali residents value themselves, and so the clients may begin to experience a phase of self-worthlessness, and undervalue their own individuality, values, beliefs; preferences and culture. Critical states of mind and unpleasant emotions can be established from such negatively reinforced thoughts, such as depression. Experiences of marginalization for the service users of a Bengali minority can be established, as there rights to choice concerning food is being infringed, and these group of residents are being treated as insignificant vise versa to the other residents who are provided with opportunities in decisions and choice of their care and health/diet. Marginalization can potentially leave the service users feeling isolated from other residents and staff of a different ethnic minority, and undervalued for their individuality, values, beliefs; culture and preferences in language and choice in this instance. This could cause a state of distress and even depression for the residents, leading to further health complications mentally and physically, if these practices and inequalities were to occur.

Reference List

Dictionary.com (2015), Dictionary: Equality [Online] Available At: http://dictionary.reference.com/browse/equality (Accessed: 22/01/15).
Disability Law Service (2015) What Is Discrimination? [Online] Available At: http://www.dls.org.uk/advice/DisabilityDiscrimination.html (Accessed: 22/01/15).
Lawrence. P, Stretch. B, Whithouse. M, (2010) BTEC Level 3 Nationals in Health and Social Care, Oxford, Sage, Heinemann.
Lawrence. P, Stretch. B, Whitehouse. M, (2010) Equality Diversity and Rights in Health and Social Care: (2.2) Discriminatory Practice, Within BTEC Level 3 Nationals in Health and Social Care, Aldworth. C, Marilyn. B, Moonie. N, Lawrence. P, Talman. H, Stretch. B, Whitehouse. M, Oxford, Sage, Heinemann, Page 68 - 69.
NHS (2015), Equality and diversity in the NHS [Online] Available At: http://www.nhs.uk/NHSEngland/thenhs/equality-and-diversity/Pages/equality-and-diversity-in-the-NHS.aspx (Accessed: 03/02/15).
Oxford Dictionaries (2015) Home > British & World English> Prejudice, [Online] Available At: http://www.oxforddictionaries.com/definition/English/prejudice (Accessed: 04/01/15).
Urban Dictionary (2015) Top Definition: Stereotype, [Online] Available At: http://www.urbandictionary.com/define.php?term=stereotype (Accessed: 04/01/15).