HND HEALTH AND SOCIAL CARE MANAGEMENT

Unit 16: UNDERSTANDING SPECIFIC NEEDS IN HEALTH AND SOCIAL CARE NEEDS

I confirm that no part of this coursework, except where clearly quoted and referenced, has been copied from material belonging to any other person e.g. from a book, handout, another student. I am aware that it is a breach of ABI regulations to copy the work of another without clear acknowledgement and that attempting to do so will render me liable to disciplinary proceedings.

Submission No: - 1

STUDENT NAME: LUCKY AKAEHOMEN
STUDENT ID: 101760
TUTOR: KHALID KARIM

Table of Contents PURPOSE OF REPORT 3 INTRODUCTION 3 (AC 1.1, M1) 4 1.1 4 AC 1.2 5 AC 1.3 6 A.C 3.1 9 A.C 3.2 11 A.C 4.1 11 A.C 4.2 11 A.C 4.3 12 REFERENCE 13

PURPOSE OF REPORT
The purpose of this report is to show my understanding of the perceptions of health, disability, illness and behaviour. It is also to show how health and social care services and systems supports individuals with specific needs.
This report will also show how much I understand the strategies that are necessary in coping with challenging behaviour related with specific needs and finally show the different approaches and intervention strategies that support individuals with specific needs.

INTRODUCTION
This report will cover a case study about Mr. K Gibbs, who was a 55year old man with severe learning disability and epilepsy. I will discuss the concepts of health, disability and illness in relation to service users in health and social care. I will also be assessing and discussing how perceptions about specific needs have changed over time whilst highlighting the impact of past and present legislation, policies and the way society and culture has changed the way services are provided. I will also emphasize the importance of diversity and further highlight how fulfilling the diverse needs of individuals with specific requirements is integral to the work of health and social care services, and how as a service provider we are able to meet these demands.

(AC 1.1, M1)
1.1
The world health means different things to several people, depending on the type of situation/scenario it is used in and so therefore the term/concept of health may be misunderstood and misused by individuals who really do not have proper understanding of the term. As competent and professional health and social care practitioners it is really important that we recognise the correct definition and perception of health, disability and behaviour else we may unintentionally cause harm to individuals in our care.
The best commonly quoted definition of health is that by the World Health Organization (WHO). “Over half a century ago WHO defined health as a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.” (WHO, 1946). The World Health Organisation, during the Ottawa Charter for Health Promotion in 1986 stated that health is “a source for everyday life, not the objective of living”. Generally health can be acceptably divided into two broad aspect- physical health and mental health. Physical health relates to anything concerning our bodies as physical entities while mental health refers to a person’s cognitive and emotional well being. Mr. Gibbs was a 55-year-old man with severe learning disability, which affected his physical and mental health. He found it hard to relate with people easily and also difficult for people to get to know him. It also affected his physical health later on when he suffered a stroke.
Disability is not just a health problem, It is a much more complex phenomenon. An individual is disabled under the Equality Act 2010 if he/she has a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on the ability to do normal daily activities, such as his/her movement, learning and lack of understanding even in dangerous situations. In the past disabled people were discriminated and seen as abnormal people and where avoided. There are different types of disability and as a social care worker it is important that we know how to cater to an individuals specific needs.
A poor health can lead to illness. According to (Naidoo and Wills, 2000) “Illness is the partial experience of loss of health”. It is majorly about how you feel, it is often considered a synonym to disease which is not always true; A person being ill does not necessarily mean they have a disease in that one may have a particular disease but still feel well. . A disease is a physical change or an abnormality in the human body, an example to distinguish disease and illness is a case just like Mr. Gibbs or people who are living with HIV or cancer- sufferers can live everyday quite normal without feeling ill or sick while taking the correct medication.
Behaviour is simply the way a person acts or conducts his/her self, especially towards another individual. “A person's behaviour can be defined as "challenging" if it puts them or those around them (such as their carer) at risk, or leads to a poorer quality of life.” (NHS, 2015). The effects of a challenging behaviour can be physical, emotional and social. Mr. Gibbs disability affected his behaviour physically and socially. It affected his communication verbally making it difficult for him to relate well with people.

AC 1.2
Over the years, perceptions towards disability and epilepsy have varied significantly from cultures and societies. Early examples of perceptions of disability show a mix of responses, some involving compassion and some condemnation. In the early times (BC and AD) the Greeks and Romans considered the sick as Inferior (Barker et al. 1953). But the "early Christian doctrine introduced the view that disease is neither a disgrace nor a punishment for sin but, on the contrary, a means of purification and a way of grace."(Munyi, 2012)
During the 16th century, however, Christians such as Luther and John Calvin indicated that evil spirits possessed the mentally retarded and other persons with disabilities. (Munyi, 2015).
“Variations in the treatment of persons with disabilities are manifest in Africa as in other parts of the world” (Amoako 1977). In some parts of Africa such as Nigeria, Ghana, Kenya, Benin etc., most individuals with disability or epilepsy are treated with total rejection like they held some sort of curse. This leaves these individuals stigmatized. Medical discoveries have shown that epilepsy is caused by abnormal neurological activity that occurs as a result of damage to the brain. Research carried out recently by the Office for Disability Issues (2009) shows that attitude towards disabled people has improved since 2005 (Office for Disability Issues. 2009). The right to freedom from discriminations for people with a range of disabilities, including those with a learning disability, has been enshrined in the 1995 Disability Discrimination Act, which says employers should make reasonable adjustments to allow an individual with disability to gain employment and ramps to be provided so that wheel chair users can access facilities the community.

AC 1.3
Legislation has gradually changed to ensure that all staff and service providers are treated well and in return treat service users in the same way as other members of society. Legislation acts have helped to set and enforce educational standards, which meet the needs of people, e.g. the Disability Discrimination Act 1995, which protect individuals with disabilities from discrimination (Rogers and Pilgrim, 1991). Legislation plays an important role in ways that services are made available for individuals with specific needs. Social policy is the only one way of encouraging and promoting ethical practice. The functions of a regulatory body go much further than disseminating policies and code of ethics.
Legislation has covered issues relating the diversity in society and culture and emphasized the importance of equality. The impact of legislation, social policy and culture goes a long way in the way services are made available for service users. As a service care provider we are bound by several legislation act such as the Disability Discrimination Act and we can never act on our societal and cultural beliefs. Societal and cultural background varies across the globe. In Nigeria where I come from people with disabilities such as epilepsy are treated with total rejection, Most Nigerians with epilepsy experience it as highly stigmatizing and something to be hidden from others. The previous negative labels, stigma, discrimination and oppression has changed positively over the last 3 decades. If we as social care providers input our societal or cultural background into our daily care with service care users it may have a negative impact. We must incorporate, consider, accept and value the differences between all individuals. In essence, it means we have to respect peoples’ differences regardless of their background or race and not treat a service user based on our beliefs, ethnicity, sex, age, race, culture or physical appearance.

Social policies are directing towards to reforms as legislations should be further
Social policies are directing towards to reforms as legislations should be further
A.C 2.1 introduced so that cases like Mr. Holland may not face the lack in assessment during the search for a care home in the United Kingdom.AAC introduced so that cases like Mr. Holland may not face the lack in assessment during the search
Social policies are directing towards to reforms as legislations should be further introduced so that cases like Mr. Holland may not face the lack in assessment during the search

for a care home in the United Kingdom.
As care givers it is important to note the needs of service users. Individual service users have a range of needs such as physical, intellectual, emotional and social needs, which must be met.
As a caregiver it is important to first identify Mr. Gibbs strengths and needs. There should be a care plan set out for him. A Care plan is a document that articulates a plan of care for and individual with specific need or disability. It is built around the needs of the person rather than expecting them to fit into an existing plan (Ritchel et al, 2003).
Mr. Gibbs general health should be considered in relation to his condition and impairments. As a caregiver we will have to make sure that Mr. Gibbs has access to a GP, Optician, a dentist if needed, development checks, hospital admissions, accidents, health advice and information. After this is done, the next thing will be to access his physical development in relation to his nourishment (he must be provided with food, drink, warmth, shelter and appropriate clothing), the different activities he loves, preferred communication style, the way he listens, responds and understands. His behavioural developments will be studied to ascertain his lifestyle, self-control, and behavior with peers and attention span.
By assessing all areas of Mr. Gibbs physical, intellectual, emotional and social personal health, we as care givers can be able to provide a suitable and comfortable home for Mr. Gibbs

for a care home in the United Kingdom.
Social policies are directing towards to reforms as legislations should be furth introduced so that cases like Mr. Holland may not face the lack in assessment during the searc for a care home in the United Kingdom
A.C 2.2

There are systems in place for supporting both caregivers and individuals with specific needs in health and social care. There are several policies and procedure in place as dilemmas can happen. For instance in some parts of the world the law states that no one is allowed to help another person to die. Whereas the person involved is in pain and does not want to live. As professional care givers we must ensure the safety of all our service users while also respecting the choices these service users make but if the choice is to harm themselves then we cannot do that because within the policies it states that we need to ensure that we protect our service users from, harm this can also include causing harm to themselves. Mr. Gibbs has little awareness when it comes to safety and as caregivers we have to follow the Health and Safety at Work 1974 to meet his safety needs accurately.
According to the Data Protection Act 1998 service care users must maintain confidentiality and that only necessary people access care plan. All files must be kept securely and locked.
There are Infection Control policies to prevent cross contamination. Everyone is to wash their hands in the correct manner to avoid transferring disease/infections. Caregivers are also to make sure that they wear gloves and aprons when dealing with bodily fluids as this prevents them from catching diseases from service users.

A.C 2.3
I have lived for quite a while in a community that offers a Community Toilet Scheme, which provides very accessible clean and safe public toilets for residents. Disabled persons can make use of the toilet for free. There is also an Institute for Adult Education which provides a range of courses such as dance classes, arts and craft etc., and equipment’s to make use of for people with learning disability. There are also Day care services that provide support for people living in the community;. It offers practical and emotional support by providing a range of activities and facilities to help stay as independent as possible and improve and maintain quality of life. There are ambulances available in cases of emergency, different activities are organized to raise awareness and highlight the needs of children and adults with specific needs. There is a Dial a ride service that provides door-to-door service for disabled people who can't use the regular transport system like the buses and trains. Also, there is a London Taxi card, which provides door-to-door transport at a subsidized rate for individuals who have serious mobility or visual impairment.

A.C 3.1
It has been observed that people with learning disability are 20 times more likely to have epilepsy. “People with epilepsy plus learning disabilities pose a challenge in terms of clinical management and research investigation, and, till date, the measurement of outcomes in this population has been limited. There have been uncertainties concerning both the ‘what’ and the ‘how’ of assessment.” (Estie et al., 1997). Each client cannot be treated in the same way, their health needs varies and so therefore different approaches and interventions are available for different types of clients with different needs. Approaches can vary in costs and availability and depend on whatever suits an individual.
There are a range of different treatments and interventions that are available to support people with learning disability and/or epilepsy. These include
DRUG TREATMENT
Doctors generally begin by treating epilepsy with medication and if medications do not work effectively in treating the condition, then they may propose surgery or any other type of treatment. The drug type prescribed will depend on factors such as the frequency and severity of the seizures, age, health and medical history of the patient. Many drugs are available to treat epilepsy, some of them include; * Carbamazepine (Tegretol or Carbatrol) * Ethosuximide (Zarontin) * Diazepam (Valium) and similar tranquilizers, * Lamotrigine (Lamictal) * Levetiracetam (Keppra) * Eslicarbazepine (Aptiom) * Phenytoin (Dilantin or Phenytek) * Pregabalin (Lyrica) * Valproate, valproic acid (Depakene, Depakote) * Zonisamide (Zonegran) * Immunoglobulins * Melatonin * vitamins * etc
These drugs are issued based on the person’s tolerance of side effects.

SUGERY
Surgeries can be carried out on epileptic patients, they are majorly carried out when the doctor notices that the seizures originates and are basically occupying just a small part of the brain that does not affect or interfere with vital functions.

LIFESTYLE CHOICES AND THERAPIES
Certain lifestyle choices can help in controlling seizures. For instance exercise can have an impact on quality of life and social inclusion rather than seizure control (kneen, 2006). Also sleep keeps the patient healthy. Sleep deprivation is known to be a trigger for precipitant for seizures (and most epilepsies. “Patients with epilepsy should therefore be advised to have good sleep hygiene. They should try to ensure regular and consistent sleep and if they go to bed later than usual, they should try to get up later the next”. (Kneen, 2006)
Some therapies to help may include yoga to reduce stress, Reduction in psychiatric co‐morbidity

A.C 3.2

A.C 4.1
Challenging behaviour can be defined as “culturally abnormal behaviour(s) of such intensity, frequency or duration that the physical safety of that person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied access to ordinary community facilities”. (Emerson, 1995). Mr. Gibbs had some problems relating with people especially people he barely knew. This will make communicating with him really challenging.
Individuals with challenging behaviors may cause harm to themselves and people around them. Research has shown that males are more likely to display challenging behaviour than females and their behaviour may be more aggressive than the females.
A.C 4.2
All the carers working with Mr. Gibbs are experienced and have achieved a minimum of NVQ level 3 in health and social care and also the manager is a well-experienced registered nurse. When dealing with challenging behaviour health care organisations need intervention plans, policies and procedures to follow. The BILD (British Institute of Learning Disabilities) policy has frameworks for physical interventions. Staff should get proper induction when employed and the clear guidelines should be written and given to employees to study in the handbook. Staff should be taught on how to manage and deal with complex situations/behaviours violence and aggression. Policies and procedures should be followed under the BILD policy framework. We as caregivers must ensure that we avoid any act that will cause harm to the service users and work in the best interest of them at all times. The General Social Care Council, Codes of Practice for Social Care Workers (Code 4), states that as ”a social worker you must respect the rights of service users while seeking to ensure that their behaviour does not harm themselves or other people. It sates that we care givers should understand that service users have the right to take risk but it is important to help manage and prevent risk to them
.
A.C 4.3
Challenging behaviour can be avoided or reduced with support. Some of the challenging behaviours are caused when service users are expressing their unmet needs. As a service provider whenever you notice a service user in a challenging state it is important to first understand why they are behaving in that manner. They may be bored or be in pains or they might feel anxious. If the signs are noticed early then this behavioural outburst can be avoided.
Mr. Gibbs carer has to ensure he feels valued and listened to; since Mr. Gibbs has a communication problem must effectively learn Mr. Gibbs preferred method of communication. Whatever puts or triggers seizures or comfort such as excessive noise, light etc., should be avoided around Mr.. Gibbs. Support should be flexible and personalised to the needs and circumstances of each individual and their family carers. (SCIE, 2011) As a good carer it is important Anticipate potential problems and intervening where appropriate.

BIBLOGRAPHY
Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

REFERENCE
Amoak, J.B. (1975). Division of Rehabilitation Status Report. Accra Ghana Ministry of Labour, Social Welfare, and Community.

ESTIE, C., KERR, M., PAUL, A., O'BRIEN, G., BETTS, T., CLARK, J., JACOBY, A., BAKER, G., 1997. A review of available outcome measures and position statement on development priorities . Learning disability and epilepsy. 2, [Online]. 6, 337-350. Available at:https://www.researchgate.net/publication/13620690_Learning_disability_and_epilepsy_2_A_review_of_available_outcome_measures_and_position_statement_on_development_priorities[Accessed 30 November 2015].

Davies, H., Powell, A. and Rushmer, R. (2007) ‘Healthcare professionals’ views on clinician engagement in quality improvement.’ London: Health Foundation

Emerson, 1995, cited in Emerson, E (2001, 2nd edition): Challenging Behaviour: Analysis and intervention in people with learning disabilities

Equality Act 2010. (2010). Information and guidance on the Equality Act 2010, including age discrimination and public sector Equality Duty.. Available: http://www.legislation.gov.uk/ukpga/2010/15/pdfs/ukpga_20100015_en.pdf. Last accessed 27th November, 2015.

Kneen, Appleton, R, 2006. Alternative approaches to conventional antiepileptic drugs in the management of paediatric epilepsy. Archives of Disease in Childhood, [Online]. 11, 936-941. Available at:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082960/ [Accessed 09 December 2015]. MUNYI, CW, 2012. Past and Present Perceptions Towards Disability: A Historical Perspective. Disability Studies Quaterly, [Online]. 32, 0-0. Available at: http://dsq-sds.org/article/view/3197/3068 [Accessed 01 December 2015].

Naidoo, J, & Wills, J., 2000, 3rd Edition, Health Promotion: Foundations for Practice, London: Baillière Tindall

NHS. (2015). Dealing with challenging behaviour. Available: http://www.nhs.uk/Conditions/social-care-and-support-guide/Pages/challenging-behaviour-carers.aspx. Last accessed 10TH DECEMBER 2015.
Office for Disability Issues. 2009. Public Perceptions of Disabled People. [ONLINE] Available at:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/325989/ppdp.pdf. [Accessed 25 November 15].

Ottawa Charter for Health Promotion, 1986. (1986). Health Promotion . Available: http://www.euro.who.int/__data/assets/pdf_file/0004/129532/Ottawa_Charter.pdf?ua=1. Last accessed 27th November, 2015.

Rogers, A. and Pilgrim, D. (1991) ‘Pulling down churches’: accounting for the mental health users’ movement. Sociology of Health and Illness 13, 2, 129-148.