Analysis of Law, Policy, and Ethical Practice in Healthcare Settings

This report delves into the intricate relationship between law, policy, and ethical practice within the health and social care sector, using the Winterbourne View case as a central example. It outlines key legislation such as the Autism Act 2009 and explores national and organizational policies, statutory guidance, and codes of practice. The report examines the failures in compliance that led to the closure of Winterbourne View, highlighting shortfalls in patient safety, unethical conduct, and the consequences of non-compliance. It further analyzes the impact of equality legislation and equity, and proposes methods to enhance compliance through legal teams, staff training, and codes of conduct. The report also provides an overview of the roles of the legislature, executive, and judiciary within the legal and policy framework, discussing relevant legislation, national policies, and ethical dilemmas. It covers the importance of ethical considerations and principles in healthcare, and offers a critical review of compliance strategies.

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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