Law, Policy and Ethical Practice in Health and Social Care: Doc

LAW, POLICY AND
ETHICAL PRACTICE IN
HEALTH AND SOCIAL
CARE

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Summarization of key policies and practices..............................................................................3
Policies that Winterbourne should have adopted.........................................................................4
Policies that were not adopted at Winterbourne..........................................................................4
Shortfalls in patient’s safety and care..........................................................................................5
Outcomes of non-compliance......................................................................................................6
Methods in which workers could have endured compliance.......................................................7
Impact of different equality legislations......................................................................................8
Relationship between law, policy and ethics...............................................................................8
CONCLUSION................................................................................................................................8
PART 2............................................................................................................................................9
INTRODUCTION...........................................................................................................................9
MAIN BODY..................................................................................................................................9
P1 How the legislature, the executive and the judiciary set out legal policy..............................9
P2 Summarize key feature of Statutory Guidance, Code of Practice, National Health Policy,
organizational policy.................................................................................................................10
P3 Relationship between key legislation and national policy...................................................11
P4: Compare national and organisational policy against national professional standards........12
P5 Explain human rights law influence and inform equal and fair treatment of others in Health,
Care and Support services.........................................................................................................13
P6 implement different legislations and policy in safe and health services..............................15
P7 describe the relationship between law, policy and ethical requirements..............................16
P8 Explaining the impact of law and policy on the outcomes of real case...............................17
CONCLUSION..............................................................................................................................18
REFERENCES................................................................................................................................1

INTRODUCTION
Winterbourne View, a hospital where patients expect safe and protected environment
turned onto a case study for studying institutional abuse due to the inhumane treatment of the
patients and also non-compliance by managers regarding various rules and assessment of the
quality of service provided to the patients in the healthcare unit. In this report, various legislative
and healthcare aspects of the Winterbourne View case study have been discussed and
recommendations will be made.
MAIN BODY
Summarization of key policies and practices
The key legislative and national policies that are applicable in healthcare sector in UK
are:
The Care Act, 2014 which states the role and importance of local authorities in prevention of
abuse and neglect of the patients and the duties of the local authorities have been reframed
making the safeguarding more regressive.
Mental Capacity Act, 2005 which identified certain categories of those people who were tasked
to take care of those patients who were mentally challenged i.e. those who could not take care of
themselves or take decisions for themselves.
Information sharing Guidance under which the management of a healthcare unit is required to
share particular information at particular time so that overall process can be improved (Waterson,
2018). This assists the medical practiotners in implementation of interventions on time and take
decisions regarding what information is to be shared or what is to be done while safeguarding the
patients.
Apart from these, there are certain codes of conduct and statutory guidelines that should
be complied with i.e. Care and Welfare of people using the services provided, safeguarding of
those people from any abuse who are using the services, managing the medicine, requirements of
the workers working in the healthcare unit, supporting the workers in the unit, assessment of the
quality of the services and care that are provided to the patient, complaints made by the users of
the services, notifying to the proper authority in case of absence or death of the user of service
under Mental Health Act, notifying other incidents as well, maintaining proper records etc. These
standards are prepared so that the management can identify what is expected of them and the
statutory compliance that they should follow in order to keep working.

Policies that Winterbourne should have adopted
There is a list of policies that Winterbourne View healthcare facility, being an institution
in UK, should have adopted in order to provide safe and secure environment to its patients
(Griffiths, 2017). There are a certain set of standards formulated by CQC, which the healthcare
units of UK are required to comply with and those standards that Winterbourne should have
adopted are:
Welfare of people using the services i.e. the patients: Since it was a healthcare unit, safety and
protection of the patients in the healthcare unit should have been the primary responsibility but
this was not the case where those responsible for the safety themselves were the ones
compromising it (Hannah, 2019).
Working staff: The staff that was employed at the healthcare unit did not have sufficient and
adequate skills and also lacked the training that is necessary for such medical practiotners. This
carelessness in the hiring process led to non-compliance of the standard which should have been
avoided at every cost.
Complaint Procedure: The process for filing and taking action for any complaints that were filed
by the patients at Winterbourne was extremely poor and despite repeated filing, no action was
taken. This is an extremely ill formulated policy which should have been rectified and in
compliance with the standard set by CQC.
Medicines: This was another policy i.e. standard that Winterbourne did not comply with and the
management was extremely irresponsible regarding where they were store, their stock levels, the
supply and requirement of mandatory authorization before issuing (McGeown, Heffernan and
Gibson, 2018). All these aspects were not considered which should have been followed.
Regular update from the management: This is another aspect which should have been
complied with where the management of Winterbourne hospital currently was not giving any
proper and regular updates regarding their various policies and practices to the regulatory bodies
like CQC etc.
Policies that were not adopted at Winterbourne
Despite a detailed and comprehensive policy formulation, there were many policies that
were not adopted by the Winterbourne View Institution:
Non-compliance of giving safe environment to the patients: Patients at Winterbourne View
were not getting a safe environment and relevant care or support tin their treatment because the

care plane that were formulated for every patient were not specific and detailed and rather than
understating the complex needs of individual patients, they formulated a standard or generalised
treatment without maintaining of adequate or sufficient records (Enston, 2019).
Failure in compliance with safety of patient standard: Instead of protecting their patients from
the abuse or maltreatment, they themselves were not giving adequate care to the patients and
when there were allegations against the hospital regarding abuse of the patients by the caretakers,
no proper statements or evidences were presented.
Non-compliance of the Medicine management standard: Patients at Winterbourne View
Institution were not given the required medicines in the required quantity and further the
management was not working in a responsible manner for proper storage or disposal of the
medicines.
Lack of trained and competent staff: Winterbourne healthcare institute failed to provide trained
care takers who could not comply with the duties and responsibilities that they are required to
perform (Rose and Farrer, 2016). The skills that the caretakers should possess in a healthcare
institute was lacking amongst the caretakers of Winterbourne Institute.
Poor Quality check systems: the quality of the care and treatment that the patients at
Winterbourne Healthcare institute received was not at par with the standards that were set by the
regulatory bodies and authorities depicting lack of any effective leadership or management in the
institution.
Shortfalls in patient’s safety and care
While reviewing the healthcare institute, CQC found that following were the major
shortfalls in the facilities and treatment provided top the patients:
 The registered provider i.e. Castlebeck Care Ltd did not given enough importance to the
quality of staff that it hired which led to exposure of the patients that were admitted in the
facility towards a risk in the treatment or care that they received.
 There were no proper technologies or systems like RIFD etc. to track the movement of
the patients and ineffective or redundant technologies were being implemented on the
patients to treat them which were compromising with the wellbeing of the patients and
thus questions were raised on the quality of the healthcare services provided to the
patients (Atkinson, Crozier and Lucas, 2018).

 There was no proper assessment of the risk that the healthcare unit was facing and
therefore, those possible scenarios in which the patient might be exposed to a certain
threat or risk were being overlooked by the staff at Winterbourne Healthcare Unit which
led to compromise on the safety and protection of the patients.
 There was no adequate training or supervision given to the care takers and medical
practiotners employed in the firm. The recruitment process through which the caretakers
are hired in the Winterbourne healthcare facility was not upgraded and was not
differentiating clearly between the efficient and inefficient employees.
 The feedback mechanisms and the monitoring and evaluation mechanisms adopted at the
Winterbourne Facility for the evaluation of the caretakers were not effective enough and
even if they were implemented, which was with irregular consistency and therefore the
safety of the caretakers was compromised with.
Outcomes of non-compliance
Due to their non-compliance, the Winterbourne View healthcare institute was ultimately
shut down by the appropriate authorities leading to complete collapse of the institute. Care
Quality Commission, which was tasked with conducting a review on the Winterbourne institute
when they were charged with abuse of the patients determined following outcomes due to non-
compliance of the standards set by them for such healthcare institutes in UK:
 CQC restricted further entry of all the people in Winterbourne Institute restraining
anybody from getting admitted there or getting their treatment done (Ellis and Abbott,
2016). This stopped any more patients from getting admitted in the healthcare facility
which was the first step towards closing down of the institute.
 CQC collaborated with the National Health Service and the local council so that they
could collectively ensure the safety of the patients that were currently admitted in the
healthcare facility and ensure that during the time taken to shift them to another
healthcare institute, they were safe and were not harmed in any manner.
 Along with NHS and South Gloucestershire Council, patients who were still admitted in
the Winterbourne facility were closely guarded and the activities of the care takers were
carefully monitored so that their health and safety could be protected at any cost.
 CQC along with other prominent healthcare societies in UK were extremely concerned
and alarmed with whatever they had found while evaluating the practices adopted at the