Law, Policy and Ethical Practice in Health and Social Care

This report explores the relationship between law, policy, and ethical practice in health and social care settings. It covers key legislation, national policies, organizational policies, and ethical dilemmas. The Winterbourne View case study is used as an example to highlight the importance of compliance with laws, policies, and ethics.

Law, Policy
and
Ethical Practice

Table of Contents
INTRODUCTION...........................................................................................................................1
PART 1............................................................................................................................................1
PART 2............................................................................................................................................7
Section 1- Description of legislature, executive and judiciary in health ans social care legal
and policy settings..................................................................................................................7
Section 2- Describe the relationship between key legislation and national policy................8
Section 3- Explain ethical practice along with examples of ethical dilemmas......................9
Section 4 reflection along with specific tasks......................................................................10
Section 5- Evaluate national system of government............................................................10
Section 6- Explain different relevant legislation and policy regarding health and social care11
Section-7 Explain the Human Rights Laws for England......................................................12
Section-8 Explain the relevant legislations and national policies........................................13
CONCLUSION..............................................................................................................................13
REFERENCES..............................................................................................................................14
REFERENCES..............................................................................................................................15

INTRODUCTION
Law refers to a system comprising of rules and statutes developed within the legal system
in order to govern the activities of people and organizations (Scalia and Garner, 2012). Policy
means a plan or course of action formulated to make appropriate decisions in aspect of the entity.
In the context of health care, ethical practice is the behaviour of the staff taking care of patients
admitted in the hospital. Every nurse is expected to act as a moral agent which means that right
actions should be taken without any negligence or mistake. This report is based on Winterbourne
View case study by covering the aspects of key legislation, national policies, organizational
policies, statutory guidance and codes of practices. Along with this, status of non-compliance of
statutes, ways to increase the level of compliance, impact of different equality legislation and
equity. In addition to this, description of the relationship between law, policy and ethics,
explanation of executive, legislature and judiciary legal and policy framework, discussion of
relationship between legislation and national policy to health and care settings. Apart from this,
ethical practice along with examples of ethical dilemmas and other laws on the organizations
have been covered.
PART 1
Overview of Winterbourne case
It was a hospital in South Gloucestershire, UK which was developed for helping the
people suffering from learning disabilities and autism. The main motive was to examine the
condition of patients for giving them proper treatment so as to enable them to lead a normal life.
The owner of this hospital was Castleback, who was provided funds to take care of the people
admitted or availing treatment in Winterbourne (Flynn, 2012). The organization was pretended to
be doing great but soon a video was showed on TV wherein Winterbourne View hospital was
slapping and hurting patients and getting them on the floor. This was enough to close the entity.
Summarise key legislation, national and organizational policies, statutory guidance and
codes of practices
Key legislations
Key legislation are the main statutes which are applicable on health and social care units
for conducting the activities in lawful manner. Winterbourne View had to follow Autism Act,
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2009, Human Rights, 1998, and various other legislations related to health and safety of the
patients.
National policies
National Policies are there for providing a direction along with processes and procedures
to carry the activities. NHS England is responsible for designing the policies to be applicable on
all health and social care units.
Organizational policies
These are the policies which are formulated by the management of the organization in
order to keep the employees on the track to provide effective services. The organizational policy
of Winterbourne was focused on providing quality services to its patients.
Statutory guidance
These are implemented by government of UK for to help the health and social, hospitals
and similar types of entities to achieve the outcomes which are important for a patient. It is
divided into different sections which should be abide by such entities (Statutory guidance, 2018).
Furthermore, the matters covered in this are assessment, person-cantered care and support
planning, safeguarding the adults etc.
Codes of practice
A code of conduct is a set of rules comprising of social norms, religious rules and
responsibilities for proper practices for an individual. Every person working in such units are
required to follow codes of practices which are uniform for all (Sclater and Bailey, 2015).
Winterbourne View failed to comply with organizational policies, statutory guidance and
codes of practices because it has been charged with serious accusation of beating the patients
which made their condition worse. It failed to adhere to laws related to safety and health of
patients. For example, the patients complains of the poor management of the hospital made them
feel unsafe which is the reason for its closure. The major findings which were obtained by the
investigator is that patients had been treated poorly and their health deteriorated when they were
in the hospital. Also, many patients rushed to the emergency section of the hospital after getting
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hurt by the staff. Furthermore, the staff was untrained and behaved rudely. Every such
organization should abide all the statutes which are applicable on them. Apart from this,
Winterbourne failed to follow the policies both national and organizational due to which the
routine of the patients got disturbed and number of disputes arose. The major findings which
were obtained by the investigator is that patients had been treated poorly and their health
deteriorated when they were in the hospital. Also, many patients rushed to the emergency section
of the hospital after getting hurt by the staff. Furthermore, the staff was untrained and behaved
rudely.
Shortfalls in patient's safety and care
Autism Act, 2009
This was the first even disability specific law in England which gave the authority to the
government for making strategy for adults with autism and to design statutory guidance for legal
authorities, councils and local health care bodies to be implemented in health and social care
units and hospitals (Autism Act, 2009). This act lays a legal responsibility on the health care
bodies to act under the guidance which is related to assessment and identification of adults with
the conditions of autism, to prepare plan for providing relevant services according to the age and
severity of the health condition. Besides this, collaboration with local arrangements for creating
the services to adults. In the context of this act, the staff of Winterbourne failed to assess the
actual condition of its patients leading to failure to provide the right treatment.
Organizational policies
According the policy set by Winterbourne, the hospital was bound to follow the
instructions given by the hospital. But the staff failed to behave properly with the patients. The
number of incidents that occurred in the past has reflected the lack of training and failure to
abide by the policies (Kacherov and et. Al., 2014). The main motive behind preparation of
policies is to provide guidelines and directions according to which all the activities will be
carried in order to avoid any mistakes or defaults. Winterbourne's organizational policies were
for the patients suffering from autism and learning disability and to provide them with right
treatment and medications. Therefore, it can be said that the staff has breached the terms of
policies and resulted in mistakes.
Ethics
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Ethics refer to act in a right and moral way which is for the benefit of an individual as
well as for the society as a whole. Health and social care revolves around the ethics, ethical
considerations and principles (Runciman, Merry and Walton, 2017). When Winterbourne was
charged with slapping ad thrashing the patients, then on receiving the complaints the
management should have been taken strict actions against such incidents. Furthermore, the
hospital should have conducted evaluation of the system followed in the hospital to reduce the
variance and make the strategies work effectively. Apart from this, it should have terminated the
nurses, doctors etc. whoever encountered with bullying the patients. Furthermore, patients'
demands were not fulfilled also they had faced negligence which is a huge factor in ethics. It is
the first rule that no staff in the hospital who is taking care of the patients work by showing
negligence. All the activities should be for the benefit of the patients.
It is necessary for the hospitals and health care units to act in the right way by being
within the legal boundaries so that in case of any breach or negligence can be reported to courts
for seeking justice.
Outcomes of non-compliance
The investigation about the Winterbourne was conducted by Margaret Flynn who was a
sister of one of the patients suffering from learning disability. On getting feedbacks from the
patients at the hospital, it is found that staff has hurt the patients physically and treated them
poorly which made their health worse. This is the outcome of non-compliance with laws, policies
and ethics which contributed to increased number of complaints were made to families, friends
and staff but no action was taken by the top management of the hospital. Also, these acts were
shown on the television to uncover the reality.
The findings directed that staff had not followed the rules which was prescribed by the
management. Also, the staff was not trained even if the necessity to provide training was a
compulsion in the statutes. Furthermore, the managers were not exercising efficiently. Also, the
management did not notify the families of the patients when they were hurt.
The above matter are adequate enough to shut down the hospital. When the government
officials and NHS found out the real situation in the hospital then these authorities took an
extensive investigation which made them pass order for the hospital to be wound up. It was a
major case in the history which raised the need to make the legal provisions, policies and ethics
stronger to increase the protection for the people suffering from such disabilities. The staff who
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made defaults were terminated from the hospital and it was hard for them to find a job after the
removal. The service users were affected who were going through the treatment as with the
closure of the entity the health care services discontinued.
Critical review of ways about compliance
Legal team: Winterbourne should have had a team for having the knowledge about the
legislations that are applicable on the organization. Also, the work of team would have been
extended to notifying the management and staff of the hospital about the amendments taking
place in the laws (Ruff, Ugazio and Fehr, 2013). Compliance with legal provisions is important for
the health care entities to keep the working legal and managed. Also, the team would have
prepared a system for ensuring that every employee abide by the legal provisions without any
breach. Besides, the team would have been informed about the hefty fines and penalties so that
contravention can be controlled.
Staff training: Training is important for making the staff know the meaning of law and its
importance. It gives opportunities to increase the level of knowledge and become familiar with
the changes occurring in external world. With the adequate training the staff could have learnt
about new policies and guidance which were necessary for to be adhere to. Also, they would
have behave differently and in a positive way. This could have saved the goodwill of
Winterbourne which could have helped it survive for a long time. It is a cost effective and
prompt method by which all the points are made clear to the staff so that they can have clarity in
their job roles.
Code of conduct: It is a document which is prepared by the organizations describing the
rules which are to be followed within the organization (Trifirò and et. Al., 2014). This helps in
better management of all the activities in a sequence and effectively. In the context of
Winterbourne, the staff should have acted according to the guidelines and code of conduct
provided by the management. The reason being, they would have provided a part dedicated to
laws, policies and ethics applicable on the hospital. It would have worked as an effective way to
comply with the legislations, policies and ethics because of the flexibility to be changed as per
the changes in legal system, ethical considerations and national policies.
Analyse impact of equality legislation and equity
Equality legislation: The legislation are related to the equality of the people viz.
Children, young people and adults. Main motive of such laws is to protect the people from
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discrimination, harassment and victimisation regarding different types of areas. UK has Equality
Act, 2010 which is also applicable on the hospitals and health care units in order to safeguard the
patients availing medical services. It is compulsory for the organizations to follow the provisions
of this act. Following the law is mandatory and there are penalties which may cause huge burden
on the organizations. Winterbourne should have followed the laws in true spirit without making
any breach. The patients who were bullied sought legal actions against Winterbourne which was
closed after the order of the court.
Equity: This concept refers to give equal treatment to every patient obtaining the service
in the hospital. Health organization should not make any discrimination on the basis of any
factors. The service should be equal for everyone by charging the same price. It is a part of ethics
which should be followed by all the staff members in the organization. It has been analysed that
equity is voluntary, it is not provided by any law or policy but merely an act of ethics which
comes from within. The staff of Winterbourne should have understood the importance of equity.
This would have stopped incidents of bullying or harassment. The impact of following equity in
providing services prevent negligence and similar situations. There is no punishment for not
following since it is not included in any law or policies.
Describe the relationship between law, policy and ethics
Law are a creation of moral values upon which the society rely and act. It governs the
behaviour of the people living in a country. Guidelines are a result of law and legal system which
give directions to individuals for doing activities lawfully. It is of binding nature. There were
different laws which were applicable on Winterbourne and meant to be followed without any
breach. These were related to autism, learning disabilities etc. The laws were mandatory to abide
by in order to avoid any legal consequences.
Policy has a huge scope and comprises of rules, taxation provisions, court decisions etc.
It is prepared by the government which should be followed by the entities as it is designed by
considering the perceived value of people. It not only formally creates sanctions and incentives
but also, implicitly approves and disapproves courses of actions, influencing culture itself. The
policies of Winterbourne had the motive to provide high quality services to patients who were
undergoing treatment. Every staff was bound to work according to the instructions contained in
the policies.
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Ethics is that branch of philosophy which views the acts of people and institutions and
puts a value on them. It struggles in a systematic way to develop principles in accord with which
persons and groups can judge the appropriateness of given actions. Every person who is engaged
in providing services Winterbourne should have acted in an ethical way for providing the
benefits to the patients in order to accelerate the recovery.
National policies are meant to provide the directions according to the vision of the
country in order to ensure the health of all the people living in the country. On the other hand
organizational policies have the main aim of forming a co-ordination in daily activities with a
clarity in the objectives and other activities. These are important to fulfil the requirements related
to health, safety and legal provisions.
National professional standards are provided by the authorities involved in Health and
Social Care for promoting the health, safety and well-being of the patients, service users and
public by providing specific standards for maintaining uniformity. National policies have bigger
scope which should be abide by the health and social care entities. It is focused on meeting the
vision and standards are to maintain the quality. On the contrary, organizational policies should
be made by considering the standards given by the national authorities. National professional
standards have positive impact on the working of the organizations pertaining to health and
social care section.
PART 2
Overview of the care home
Foxbridge House Care home is an organization that provides nursing care to the patients
with dementia. It provides high quality services which may be customised according to the needs
of the people availing the services. It is located in United Kingdom so that majority of people can
utilise the services.
Section 1- Description of legislature, executive and judiciary in health ans social care legal and
policy settings
Legislature: This is a part of the government which is responsible with the
implementation of laws in the legal system that will govern the acts of individual and
organizations. The laws are inserted in the constitution with the objective to extend to all the
parts of the country for maintaining law and order. The government evaluates the current laws
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and rules which the health care organizations are bound to follow in order to pass new laws for
making the system effective.
Executive: This is about the execution of number of rules and legislations which are
provided by the government. The officials of the government ensure that all the laws and rules
are enforced effectively. A part of the government is dedicated to oversee the implementation of
the hospitals and health and social care units for assessing the existing laws which are applicable
on organizations engaged in working of health and social care.
Judiciary: It includes courts and tribunals for settling number of cases arising from
disputes and conflicts. Different types of laws are made on the basis of judgements passed in the
courts. These are helpful in providing the right guidance in order to help the health and social
care entities to work without any hindrance.
These systems work together to understand the legislations which have been enacted by
considering the current scenario status of health and social care units working in UK. The
formation of legal provisions begins with the legislature whereby laws are passed which then
overlooked by executive team to ensure the enforceability of the legal provisions and if disputes
or conflicts arises then these are resolved in the courts. These take into account the past decisions
and report in the implementation and enforcement of various legislations enacted for maintaining
the legality. Apart from this, policies are also formed on the basis of legal aspects which are
aligned with the vision of health care sector. The practitioners in such organizations are expected
to follow these in so that legal backup can be provided. In the context of Foxbridge House Care
home, it should focus on identifying the possible laws which are applicable on it. Also, the
policies should be made according to the legal provisions which may affect the working of
Foxbridge House Care home.
Section 2- Describe the relationship between key legislation and national policy
Legislations are essential for carrying the activities in a lawful manner. Government of
UK has enacted laws in every sector and industry which regulate the working of organizations so
as to keep the element of legality. Similarly, there are specific laws which are applicable on units
having the objectives of taking care of people suffering from diseases or disabilities etc. Some of
the key legislations which are applicable of Foxbridge House Care home Health and Social Care
Act, 2008 and Care Quality Commission (Registration) Regulations, 2009. These are enacted
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with the motive to make such organizations to conduct activities by complying with the legal
provisions and not to breach or contravene any law.
On the other hand, national policy provides a framework which is inconsistent with plans
and visions in the coming years. The main objective of national policy for health and social care
is to ensure that plans are being completed by protecting the existing patients who are availing
the services. National policies are formed on the basis of national interest and for the benefit of
the country. Heath and social care units have to follow the national policies to increase the
benefits for the patients. The national policies for health care units are meant to provide
principles which are expected to follow. There is no compulsion to comply the provisions of
mentioned in the policies.
Both laws and policies are required for health and social care entities for maintaining the
efficiency of the organizations belonging to this sector. The laws have greater scope and policies
are the creation of outcomes of legal provisions. Law as well as policies have similar intention
which is to bring equality in the society and actions to be taken in future. Also, policies can lead
to formulation of new laws. These are to provide guidelines and rules which are applicable in
order to govern the activities so that future projects can be completed smoothly.
Section 3- Explain ethical practice along with examples of ethical dilemmas
Ethical practice is an essential feature of health and social care which has vast scope. It
refers to set of standards of moral conduct and judgement which should be followed by the staff
in providing the services of health and social care. Motive of ethical practices is to help the
employees perform their work professionally by taking into account the demands of the public.
In the context of health and social care, the staff should know what he is doing and what would
be the consequences to judge the rightness and wrongness of the act.
Ethical dilemma is a problem in the decision has to be made between two possible
alternatives, neither of which is absolutely acceptable from an ethical perspective. In other
words, it is a situation in which a choice has to be made between two equally undesirable
options. The reasons for occurrence of dilemmas can be behaviour or attitude, personal values,
organizational goals etc. There is a process which is used to resolve ethical dilemma. Some of
the ethical dilemmas which can occur in Foxbridge House Care home can be where the nurses
may face difficulty in disclosing the complete matter knowing that this could give mental stress
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to the patients and family members. Another example could be when patient and staff gets into a
dispute, the situation become tough as it is difficult to support one side and neglect another side.
Ethical codes of practice or code of ethics is basically a document which outline the
mission and values of the business or organization in which the professionals working in the
entity are expected to follow. When ethical dilemmas occur, it should be dealt by not breaching
the code of conduct. The usual practice of Foxbridge House Care home to resolve any sort of
ethical dilemma is resolved by identifying the problem, collect the evidence and relevant data,
checking the regulatory issues, and other aspects followed by corrective measures which will
help to overcome the dilemma.
Section 4 reflection along with specific tasks
Foxbridge House Care home has gone through number of ethical dilemmas in which the
specific tasks were carried out to ensure the effectiveness and efficiency of the working are
maintained. An examination has been conducted in which, I have concluded that it has been
doing good in the sector in which it is operating. It is focused in meeting the national
professional standards regarding safe and non discriminatory practice in health and social care.
Some of the examples which Foxbridge House Care home has conducted are as follows:
1. It has formulated a policy in which the main focus has been put on adherence to the
national professional standards in order to provide the minimum criteria which is to be
followed. It has been prepared by looking into the need to bring changes in the exiting
scenario and to increase the quality of the service.
2. It has provided required training to the staff taking care of the patients. They are made to
ensure that ethics are followed along with number of principles which are mentioned in
the ethical consideration. Furthermore, they have been made to understand the
importance of aiding by these standards.
3. It has taken feedbacks from the patients in order to know the reality. This has helped in
knowing the actual services being provided by the staff Foxbridge. Also, it has
contributed in enhancing the quality and fast service by ensuring patients are getting the
right services which are required by them.
These have been completed by forming a co-ordination among all the people working in
Foxbridge. Also, support from the patients have been sought to put their demands as well as
queries in front of the management to resolve them.
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Section 5- Evaluate national system of government
National system of government refers to set of political institutions which have been
empowered by the government to exercise their power in different parts of a country. It is
divided into different systems which has its own process and power. The impact of having a
national system of government is that, common laws and standards are formed which are to be
followed by health and social care practitioners. The staff should abide by the policies and
standards which are provided by the national government so as to maintain uniformity in the
working of these units. Also, there is common consequences for breaching the legislation and
regulations. It is compulsory for the employees in health and social care organizations to follow
the guidelines and policies of the national government to remain a part of the whole system.
It is important because the ultimate power to make a decision is in the hands of the
government. An organization not following what has been instructed to all the health and social
care entities may be wound up if the activities are not beneficial for the people availing services
and others as well. Therefore, it is necessary to follow each and everything which has been made
a compulsion on the health and social care entities.
The main aim of national system of government is to provide a fixed and common rules
which will be applicable to all the health and social care organizations irrespective of any
difference. Also, it works to create a system which will increase the efficiency of the
organizations and to make the staff work for creating huge benefits for the patients as well as for
the society.
The main issues which can arise can range from non-compliance of standards by some of
the health and social care units. Also, there can be number of situations in which the need to
make changes in policies, legislations and standards can occur. This can increase the disputes
and conflicts between many health care entities.
The government should make the laws and policies strong by including more provisions
and clauses in which strict actions will be taken for those who have intentions to not to comply.
This will increase the compliance level so that health and social care units can act in more
desirable way.
Section 6- Explain different relevant legislation and policy regarding health and social care
There are some key legislations which are as follows:
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 Health and Social Care Act, 2012: This act was introduced for various legal duties
which are important for the health of patients in health and social care organizations. It
provides certain duties which should be abide by staff while conducting their activities.
Furthermore, the law keep changing which should be known to the employees for better
management. Equality Act, 2010: This act is directed towards maintaining equality with all the patients
and other people who wish to avail the services. It protects the individual against any sort
of discrimination or harassment. The entities engaged in health and social care have been
charged with the case of discrimination. Therefore, this law ensure that each person is
protected against any such acts.
 Social Value Act, 2012: This act requires local authorities and health sector bodies to
consider economic, social and environmental well-being in procurement of services. The
main motive of this act is to reduce the health inequalities by applying clear actions on
the basis of social determinants of health. By complying with this, health and well-being
of people can be increased.
These are some of the prime laws which should be abide by the health and social care
units in order to carry the work lawfully. These laws can be implemented by the Foxbridge by
forming a team which will overlook the legislations being followed by it. It will be responsible
for making the organization aware about the new laws which will be applicable. Furthermore, the
amendments will also be notified to all the organizations. Also, it will give training to the
employees as and when changes in these legislations occur. In addition to this, employees should
be given the training for letting them have the information about legal provisions which the
Foxbridge need to abide by. In this way, it will ensure that the activities are being conducted
lawfully without making any breach or contravention.
Section-7 Explain the Human Rights Laws for England
Human Rights Act, 1998 was passed by the Parliament of United Kingdom which
contains rights which should be followed by the people living in the UK. This act is applicable to
all the individual whether or not a British Citizen. A foreign national, a child, adult, prisoner or a
member of the public, all are included in this act. The act is important in maintaining a
environment in which everyone is treated equal.
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Every individual holds the right to be treated just and fair and in no case, they should be
made part of something which is wrong and unethical. The staff of Foxbridge can follow these
basic rules for maintaining equality which are as follows:
 Every person should be welcomed in the premises without being discriminated and given
the right services.
 A person should be given receipt for the money paid by them.
 It should be up to the person himself/herself, which doctor he or she wish to meet and
see.
Section-8 Explain the relevant legislations and national policies
Health and Social Care Act, 2012: This act was introduced for various legal duties
which are important for the health of patients in health and social care organizations. It provides
certain duties which should be abide by staff while conducting their activities. Furthermore, the
law keep changing which should be known to the employees for better management.
Equality Act, 2010: This act is directed towards maintaining equality with all the patients
and other people who wish to avail the services. It protects the individual against any sort of
discrimination or harassment. The entities engaged in health and social care have been charged
with the case of discrimination. Therefore, this law ensure that each person is protected against
any such acts.
These should be considered while assessing the work safety and healthy in the health care
units. These laws provides certain rights which states that organization should work according to
the main motive of the act. For example, Equality Act protects the individuals from any sort of
discrimination hence, staff should act in a way which is appropriate for the all the people without
any discrimination.
CONCLUSION
From the above matter, it has been concluded that law is the body of rules which help in
governing the activities of all the people living in the country. The scope of legislations extend to
organizations operating in the country. There are specific laws which are implemented on
hospitals and health and social care units for carrying activities lawfully. In addition to this,
policies are for the directions according to which the visions are attained. On coming to the
ethics which makes a person to distinguish between right and wrong. These assist an individual
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for exercising the moral values in protecting the lives of the people availing the services. Besides
this, the importance of law, policy and ethics have been shown by forming a connection between
these also, the impact has been shown. Along with this, it is mandatory for health and social to
make law, policy and ethics as a part of daily activities. The ultimate outcomes of following
these are to avoid legal incidents which may add extra burden on the entity. Furthermore,
contribution of national policies and standards have been discussed which keep uniformity and
standardization within all the health and social care units and hospitals in a particular country.
These are compulsory to follow otherwise all the activities can be impacted in a negative way.
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REFERENCES
Books & Journals:
Scalia, A. and Garner, B.A., 2012. Reading Law (p. 331).
Flynn, M., 2012. Winterbourne View Hospital: a serious case review. South Gloucestershire
Safeguarding Adults Board, South Gloucestershire.
Sclater, N. and Bailey, P., 2015. Code of practice for learning analytics.
Kacherov, V., and et. Al., 2014. System and method for ensuring compliance with organizational
policies. U.S. Patent 8,713,173.
Runciman, B., Merry, A. and Walton, M., 2017. Safety and ethics in healthcare: a guide to getting it right.
CRC Press.
Ruff, C.C., Ugazio, G. and Fehr, E., 2013. Changing social norm compliance with noninvasive brain
stimulation. Science. 342(6157). pp.482-484.
Trifirò, G., and et. Al., 2014. Combining multiple healthcare databases for postmarketing drug and vaccine
safety surveillance: why and how?. Journal of internal medicine. 275(6). pp.551-561.
Online:
Statutory guidance. 2018. [Online]. Available through
:<https://www.gov.uk/government/publications/care-act-statutory-guidance>.
Autism Act, 2009. [Online]. Available through
:<http://www.legislation.gov.uk/ukpga/2009/15/section/2>.
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