Reflection on Practice

This document provides a reflection on the practice of person-centred care, including a holistic approach to care, policies, regulations, and legislations for effective practice, and the challenges faced in implementing person-centred care. It discusses the importance of considering the social and medical models of care, as well as the dilemmas faced in providing effective care. The document also explores the policies and regulations, such as the Key Lines of Enquiry (KLOE) and Safe Hospital Framework, that healthcare settings must follow to deliver person-centred care.

REFLECTION ON
PRACTICE

TABLE OF CONTENTS
PART A...........................................................................................................................................3
Holistic Approach to Person-Centred Practice............................................................................3
PART B............................................................................................................................................5
Policies, Regulations and Legislations in order to deliver effective Person-Centred Practice....5
PART C............................................................................................................................................8
Reflection and ways to develop the skills related to healthcare and provision of support service
......................................................................................................................................................8
REFERENCES................................................................................................................................1

PART A
Holistic Approach to Person-Centred Practice
Person-centred care approach mainly emphasize on the personal needs, wants, desires and
goals of the individual such that they become the centre of attraction in the nursing and care
process (Northway and et.al., 2017). Under this, the healthcare professionals identify the needs
of the individual and keep them on priorities. Person centred approaches also put the families of
the individual at the centre of every decision and consider them as experts in order to obtain the
best outcome.
In order to implement the person centred care, the practitioners must analyse each and every
aspect of the patient before taking any decision. There can be many approaches in which person
centre practice can be given to the individual. The best and the simplest approach to adopt the
person-centred care at the setting can be as follows:
The engagement of staff is necessary in providing the person-centred care as they can help in
analysing the various social and medical needs of the person. Practitioner must start by asking
the patient about himself and his family. This will build strong relationship and also creates a
sense of trust between the practitioner and the patient (Moore and et.al., 2020). The practitioner
must not hesitate to ask the same question again and again as it is much necessary to know
about the one the practitioner is giving person centred care. The familiar people must also be
involved in the practice as it helps the patient to recover emotionally. Doctor must also invite the
client to express his own choices as it will become easy for him to receive the care. The
conveying of the message to the patient must be in a very simple and understandable language
so that he can easily follow them. There must be proper knowledge provide to the patient
regarding the medication, its need and also the time schedule about the medicines which are to
be taken at which time.
Therefore, the above approach can be proved helpful to the staff and the students who need to
implement such care in the setting whether home or the hospital. But, there are many factors that
they must consider while giving such care. The social and the medical models must be focussed
upon simultaneously during this care (Petty and et.al, 2019). Where the social model focusses
more on the environment, social and economic determinants, the medical model treats the
individual as a patient and applies required medical knowledge on him to treat the disease. The
social model helps in reducing the inequalities regarding the age, gender, race, culture, location

and the socio-economic status as equity plays a major role in health service delivery. The
medical model analyses the symptoms of the patient which is referred to as illness and strives
hard to eradicate it. Both the models need to be addressed by the practitioner as physical and
mental health of the person are equally important.
Though implementing such care is believed to produce the best positive results but after
considering all such factors also, the practitioner faces wide variety of challenges which are to
be meet up in order to deliver effective person-centred care. The main challenge faced is to keep
an eye on the patient constantly. It becomes more difficult when there is much work load on the
practitioners which divert them in any way (Riachi, 2018). This could be solved by prioritizing
the works as keeping the person centred care on the top priority and others after that as the
patient is the first and foremost responsibility. The another issue can be created when the patient
becomes uncooperative. It becomes very difficult for the doctor to provide care to the patient
which is best in the eyes of the doctor but the patient is not ready to receive it. This creates a
sense of distrust among them which hinders the improvement. In order to resolve this problem,
the master must create a sense of loyalty by asking the patient the same question more than 2
time in order to know more about him. The doctor must also aware the patient about the need of
the care and how it can be helpful in improving the overall health. The lack of resources also
becomes the issue while delivering such care (Barber, Saunders and Barnett, 2018). In this
instance, the practitioner must not affect the care and the practice but make the best use of the
available resources and must inform the other departments of the settings to provide the
necessary resources within the time-frame. The another challenge can be faced when the patient
makes choices which are harmful for him and the practitioner cannot allow doing so. In this case,
the practitioner must not force the patient to go according to him but must be ready with the
choice of the patient after considering all the factors (McCormack and McCance, 2016). The
recognition that the person had expertise and knowledge that is required to be taken into account
is better option. Therefore, the approach mentioned above proves to be the best way to
implement the person-centred care in which the social and medical determinants are also
addressed. It is considered to be the holistic approach which can be taught to the staff in order to
adopt such practice.
Dilemmas faced in implementing effective person-centred care

There are various dilemmas faced when the effective personal care is implemented. This
can be better described by considering a case scenario. This becomes more challenging when it is
to be given to the elderly people. For example, Mrs. A is suffering from dementia. The woman
was under complete observation in a 36-bed acute care unit. The 65-year old woman was
suffering from many other medical problems like diabetes, end stage renal disease, hypertension,
cardiovascular disease along with dementia. She was admitted in the hospital and was given
haemodialysis treatments. The practitioners and professional were taking care of her and also she
was under personal centred care. But during the treatment, she sometimes outbursts and
expresses physical and verbal aggression towards all the people including staff, practitioners etc.
They had to bear those aggressions sometimes leading to violence by that lady but had to give
proper treatment and support. She was all alone from the family as his son also left her because
of some property issues and she was suffered from these all diseases due to stress and tension.
The person centred care givers took care of her and faced various dilemmas like anger,
aggression, shouting, violence and many more. they cope up with all these and given proper care
and treatment (Dilemmas in providing patient-focused care, 2003).
PART B
Policies, Regulations and Legislations in order to deliver effective Person-Centred Practice
The workplace setting implements the legislations of two systems mainly such as KLOE (Key
Lines Of Enquiry) and Safe Hospital Framework. Both the systems ensure the health and safety
and the safeguard of the patients and the other people but have different policies and legislations
(Feo and Kitson, 2016).
The KLOE is the biggest change introduced by the CQC (Care Quality Commission) which
ensures the people in the system receives the safe, effective and high-quality care (Key Lines of
Enquiry (KLOE) explained, 2020). Under this system, the setting needs to ensure five major
points which are as follows:
1. The clients, service users, staff, visitors and the families are protected from the abuse and
the avoidable harm. They must feel safe in the hospital and must be free from any type of
misbehaviours.

2. The treatment provided to the patient must be effective such that they result in the best
outcomes and promote satisfied quality of life and must also be evidence-based wherever
possible.
3. The patient must receive holistic care and the staff must be involved in all the processes
of treatment, and they must treat the patient with kindness, dignity, respect and
compassion (Renton and Master, 2016).
4. The services in the setting must be enough organized to meet the need and demands of
the people.
5. Hospital must be well-led which means the leadership, management and the governance
at the place must be maintained. It must also assure the high-quality delivery of person
centred care, supports the learning and innovation and open culture must be promoted.
All the above mentioned points are followed by the care setting as the CQC monitors that these
points are followed by the hospitals or not who are using the KLOE system.
On the contrary, the medical institution also implements the Safe Hospital Framework which
mainly protects the hospitals from the disasters and emergencies. It provides a structured
approach so that the hospitals can be prepared for all types of hazards (Rowson and McSherry,
2018). It also ensures that the hospitals have a wide support system to be able to fulfil their roles
in the delivery of health service in such situations. The main aim of this system is to protect the
hospital buildings, equipments and the critical systems. It also assures that the hospital is safe
and resilient to the upcoming risks such as climate change and many more. This also states that
the setting deliver right level of care to those who are in urgent need of treatment in disaster
situations. The safety must be an integral part of the national and community DRM policies and
national emergency legislation as well (Aase and Waring, 2020). The healthcare setting must
also manage the equipments, financial resources, supplies and medical teams in the worst
situations of hazards.
The health centre follows all the norms and policies of the Safe hospital framework to make
itself prepared for the patients in case of disasters. The overall management of the healthcare
setting is always ready for all types of risks.
There are numerous challenges faced by the management and the nurses in order to follow and
incorporate these systems at the place but here are various legislations and regulatory measures

which needs to be followed by the healthcare setting in order to implement these systems
effectively and to address the overall issues that can be generated while delivering the Person-
Centre care (Person-centred care: challenges and changes to the training of psychiatrists, 2020).
The main challenge faced by the practitioners is to decide whether the treatment to be provided
must be best from the point of view of carer or the family and the patient. This keeps him in
dilemma to follow which practice and when. The practitioner also have to focus on the abilities
of the patient to respond to the respective care. In order to meet up these types of challenges, the
healthcare setting must follow the Health and Social Care Act 2008 which is also used in
various regulations of the government in 2014. The main intention of this regulation that the
person who is receiving the treatment or the care is specifically personalized for them
(Regulation 9: Person-centred care, 2020). By using this, the practitioners are suggested with the
actions which can fulfil their needs and preferences. Practitioner before giving the treatment
must consult and take approval for the same from the family member or the person who is
lawfully acting on their behalf (O’Hara and et.al., 2018).
The legal authorities must be considered but the Mental Capacity Act 2005 explains that it is
the duty of the practitioner to consult the carers, families or advocate in the processes of
planning, management and review of the care (Cassidy, 2018). If the system does not follow
such regulations, CQC can take regulatory actions against this and refuse the registration.
The another challenge which can be faced by the psychiatrists in delivering person centred care
is to make the approach more collaborative or co-productive along with respecting the personal
needs and desires (Jayes and et.al., 2020). In order to meet up this challenge, the healthcare
facility can follow the principles of Care Act 2014 which places the vulnerable person's well-
being and the needs at the forefront of the safeguarding process (Person-Centred Care, 2020).
This helps the healthcare setting to come to a decision by involving the patient and the
nominated person. In order to be a part of this Act, the healthcare centre must follow these six
principles- Empowerment, Protection, Prevention, Proportionality, Partnership and
Accountability (Burton, 2017). Principle of Empowerment encourages the practitioner to
support the patient in such a way that he becomes able to take his decisions confidently and is
aware about the outcomes after the treatment. Protection principle suggests the healthcare
specialists to provide clear and understandable information to the client so that in case of any
abuse he can approach to them and respond immediately in any dangerous situation (Stanley,

2016). The doctors can use the principle of proportionality by making the safeguarding processes
proportionate and involving the patient in the decisions as they can give input on what actions
impact them mostly and their quality of life. The practitioner must also develop partnership with
the local communities and services as if the safeguarding issue is submitted by multiple issues,
the government react on it quickly and confidently. Data Protection Act must also be followed
under this as it is the solution to the biggest challenge to keep the information of the patient
confidential. Caregivers should only share the information if permitted by the person whom the
information belongs (Iacobucci, 2017). Under the accountability practice, the vulnerable person
and the nominated once must e informed about every change made in the care plan so that they
become aware of the role of every person and can contact them accordingly. The team, staff
members and the support channels must also be abreast of all the decisions to be updated.
All these Acts and regulations will also help the medical setting to implement the two systems -
KLOE and the Safe Health Framework. By using these safeguarding regulations, the
practitioners can easily integrate these systems in the healthcare setting in order to deliver the
best person-centred care.
PART C
Reflection and ways to develop the skills related to healthcare and provision of support service
In my opinion, Person Centred care is much important to the patients as it helps the carers
to refocus on crucial aspect by fulfilling the needs of the patient beyond their disability. I
personally realized that the patients not only receives the better quality care but it also enhances
the healthcare setting as a whole. It also follows all the legal aspects as it is one of the thirteen
fundamental standards of Care Quality Commission (CQC). Person-centred care puts the
individual at the heart of the care (Crowe and Manley, 2019).
There can be many ways and approaches in which the person-centred care can be delivered but i
mostly use the Six-theme Framework in order to achieve the best outcomes of the care. This
was also appreciated by my manager also, and he wanted me to share my experiences and views
regarding this framework so that other staff and the students can also implement it in further care
plans. I consider basically three themes which are People, Practice and Power which have two
sub-themes each (Byrne, 2020.).

The Six theme framework I use while delivering the Person-Centred care (PCC) is described as
follows:
Theme 1: People
I used this theme by analysing the needs and desires of the people who require PCC and
integrated human kindness and respectful behaviour in the practice.
Recognising uniqueness
Under this, the patient must be treated as unique and its wants must be considered different as
compared to others. This will ensure that the unique and tailored care is provided to the patient
based on the needs. This skill to consider other person unique can be achieved by working in
diverse environment in which the person is supposed to behave accordingly with different
people.
Partnership
I believe that there must be an effective relationship between the healthcare provider and the
receiver which helps in facilitating information, knowledge and the decision-making process.
This can be evaluated in context of cohesive and cooperative teams and mutuality between the
provider and the receiver (McCance and et.al., 2020). This skill can be achieved by engaging in
group discussions where the tasks can be achieved by working in collaboration.
Theme 2: Practice
After addressing the needs of the patient to be fulfilled, it must be implemented in the practice of
the healthcare setting which is impacted by professional and system factors.
Doing
The major thing I realized while providing such care is that the practitioner must have certain
skills like communication, respecting the patient and values, compassion, empathy and especially
non-judgemental behaviour (Waters and Buchanan, 2017). This enhances the effectiveness of the
practice and much better outcomes. While delivering this care, nurse must consider the dignity,
privacy and the ethical behaviours along with the addressing the physical as well as emotional
needs.
Space
I, as a practitioner, suggest other staff to be flexible within the care and offers wide variety of
choices to the patient by creating many opportunities for them to engage. Nurses must
understand the life's history of the person, make eye contact and address him by the names to

make them feel more comfortable (Carvajal and et.al., 2019)). Helping, caring, providing
attention, ascertaining priorities and then doing the right things are evident under this practice.
Theme 3: Power
I always considered the patient as an expert and never expressed any power in treating him. This
can be suggested to the other nurses that the balance of power must be facilitated between the
care provider and the receiver.
Power over one's care
I realized that the practitioner must analyse the strengths of the patient and then support the
person to become self-managing and self-efficient. The concepts of control, rights, patient
involvement and participation can be integrated in giving the power to the patient to plan the care
and make decisions instead the nurse being self-governing. The transference of the information
must be the responsibility in order to maintain the personal autonomy of the care receiver. I
believe that one can achieve this skill by working in a democratic environment where the top
management also considers the views of the employees important and valued.
Power to practice PCC
This section of framework helped me in critically evaluating the practice of PCC and the
traditional biomedical models of care (What is person-centred care and why is it important?,
2020). Those models basically focussed on the personal needs and partnership with the
individual. Many issues were identifies in those models like the workplace and ward culture,
leadership, policies and practices, environment and the insignificant outcomes. But the PCC
helped in improving the overall quality of life of patient. PCC addresses all the above mentioned
aspects of patient and then decides for the desired treatment and care. It also follows various
standards and regulations which helps in resolving the mental conflicts in the mind of the nurse
to come out from dilemma of what should be done and what must be (Patient-centred care
explained, 2020).
Therefore, if the staff and the nurses follow the above mentioned approach effectively, then they
can be proved as the best practitioners for delivering person-centred care. In order to implement
all these, they must have some sort of skills including communication, team-working, respecting,
understanding, leadership and many more (Principles of Person-centred care, 2018). These skills
can be developed by various online tools and practices and also by participating in certain

activities where the goals can be achieved by performing in collaboration with others. I realize
that I have maximum skills among these and needs to develop the team-working skills which I
can develop by encouraging others to follow this six-theme framework and then can work as an
effective team to deliver person-centred care which can motivate them, makes them feel happier
and independent, understand themselves more, stick to the treatment plans and also behaves
positively towards the care (Principles of Person-centred care, 2018).
Short, medium and long term goals in terms of healthcare
Short term goals can be achieved in less than two or three months
For example, in this case, the short term goal is to train the staff about the approach followed
which gave the best results regarding the person centred care.
Medium term goal in this case is training the staff to use the six theme framework in the next
cases when person centred care is required. They must try this approach under the supervision 2-
3 times, then only they must implement it independently.
Long term goal here is that the whole staff is using the six-theme framework in implementing
the person-focused care and the organisation is being greatly benefited by this. This satisfied the
patients and the practitioners both.

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