Law, Policy and Ethical Practice in Health and Social Care: A Report

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Law, Policy and Ethical Practice in Health and Social Care
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Table of Contents
Introduction......................................................................................................................................3
Part 1................................................................................................................................................4
Part 2..............................................................................................................................................13
Conclusion.....................................................................................................................................23
Reference List................................................................................................................................24
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Introduction
The execution of any social and healthcare practice by an organisation is associated with
extensive adherence and inclusion of multiple legislations present in the nation of operation as
well as the local area of operation. This includes multiple laws, the policy as well as ethical
practice that are generally recommended and directed in a health and social care organisation.
The aim of this study lies in the identification of the multiple policies and legislations that a
social and health care organisation would have to adhere to for efficient execution of the project.
The scope of this study lies in the development of a brochure in the domain of legislation used in
the segment of health and social care.
For the effective development of the study, it has been divided into two segments. The first one
includes the study of the potential approach in terms of legislation that Winterbourne View
should have taken into consideration for the execution of its service. The segment, however, is
associated with the development of a brochure for new individuals induced in social and health
care. These individual sections would be characterised by the multiple applicable legislations
that would include the Health and Social and Care Act of 2008.
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Part 1
Introduction
This section would be associated with the comparative and critical analysis of the CQC report of
Winterbourne View. The aim of this section lies in the potential legislation that the organisation
should have taken into consideration to execute its operations.
Winterbourne View is a 24-bedded organisation that has been involved in the treatment of adult
having learning disabilities as well as complex needs and behavior (Cqc.org.uk, 2019). The
organisation essentially services those individuals that have been detained under the Mental
Health Act of 1983. The report provided by the CQC identified ten essential standards that the
organisation has not been meeting for many months.
Summarisation of key legislation and national policies, organisational policies, statutory
guidance, and codes of practice in health and social care
In the segment of health and social care, multiple legislations is required to be considered by an
organisation involved in the health and social care segment.
In the segment of key legislation, the following exists for an organisation to abide:
 Health and Social and Care Act of 2012: Develops a dynamic relationship between the
mental health and physical health that is required to be provided by an organisation
(Legislation.gov.uk, 2019).
 The Care Act of 2004: This enables the development of people’s independence and well
being (Gov.uk, 2019)
 Data Protection Act of 2018: This provides an effective framework for maintaining the
secrecy of treatment and potential results associated with the health and social care users
(Legislation.gov.uk, 2019)
 The Human Rights Act of 1998: Enables fair and humane treatment of all individuals
without any sort of discrimination (Liberty Human Rights, 2019)
 The Mental Capacity Act of 2005: This act provides guidelines and decisive power to
individuals to execute decisions on behalf of those adults that are incapable to take
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decisions (Nhs.uk, 2018).
In the segment of national policies and regulations organisational policies and statutory
guidance, the following exists for an organisation to adhere:
 Care Quality Commission (Registration Requirements) Regulation of 2009
 The Controlled Drugs (Supervision of Management and Use) Regulation of 2013
 The health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulation of
2015
The codes of practice in the health and social care that an organisation is required to adhere to
include the following:
 Working with extensive collaboration with the colleagues to ensure the delivery of high-
quality service to the user and the representatives of the users (skillsforhealth.org.uk,
2019)
 Striving to improve the quality of healthcare through regular professional developments
and adherence to strict frameworks provided by care commissions as well as local bodies
 Open-end communication within the organisation and develop long end relationship with
the patients to reduce the probability of self-harm among mentally unstable individuals.
Legislations that should have been in place at Winterbourne
For the mentioned organisation, multiple legislations should have been in place. This would
include the following:
 The health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulation of
2015: This would be because of two reasons. First, adherence to such regulations would
enable the organisation to provide effective service to the users (DeVoe et al., 2016).
This would have reduced the negative impact of the fourth outcome. Second, it would
enable the integration of multiple methods that have been active in the three-storied
health care service provider.
 The Mental Capacity Act of 2005: This would be because; adherence to the same would
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enable the development of the effective systems for handling complaints and external
decisions. However, the organisation had no place for such issues and individuals were
not supposed to make any complaints.
 The Human Rights Act of 1998: Multiple sections of this act should have been in place in
the organisation due to two reasons. First, the inclusion of this legislation would have
reduced the probability of closure recommendation of the organisation. Second, it would
have reduced the scope of the abuse by the employees of the organisation on the admitted
patients.
 The Controlled Drugs (Supervision of Management and Use) Regulation of 2013: This
regulation should have been associated with the organisation due to two reasons. First, it
would have provided an effective framework for conducting operations. Second, it would
have reduced the scope of occurrence of unsafe care as well as treatment of the adults
having mental difficulties as well as communication ones (England.nhs.uk, 2019).
Explanation of the laws and policies that were not being adhered to with relevant examples
Winterbourne was not adhering to multiple legislations. This includes the following
 The health and Social Care Act 2008: Based on the report provided by the CQC, this
would be due to two reasons. First, the CQC found that the organisation failed to ensure
the safety of the care users associated with the organisation. Hence, based on chapter 2,
section 3 of the act, managers is required to be registered with the government
(Legislation.gov.uk, 2019). However, during and post the inspection by the CQC, the
organisation essentially fired 15 of its employees as it was in violation of the mentioned
act.
 The Human Rights Act of 1998: Multiple legislations of the mentioned act include
providing health and social care services in tune with the demands and safety of an
individual. Hence, this act was not in place due to two reasons. First, based on the CQC
report extensive abuse was identified by the commission (Cqc.org.uk, 2019). Hence,
human rights have been breached by the organisation. Additionally, since the
organisation failed to mitigate the potential occurrence of risk as well as include
untrained employees to conduct the operations, the human rights of choice and has been
breached.
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 The Controlled Drugs (Supervision of Management and Use) Regulation of 2013: This
legislation is associated with the development of governance drug administration to the
patients as well as providing frameworks to situation management in cases of overdose or
allergic reactions. This legislation has not been adhered by the organisation due to two
reasons. First, based on the report by the CQC, the organisation failed to provide
effective skill development and training to the employees. As a result, they lacked the
awareness of situation management and effective administration of the medicines.
Second, the report suggested that there was poor management of drug and its
administration. As a result, multiple provisions of the mentioned act was not present
being adhered to by the organisation.
Explain in detail what the shortfalls in patient's safety and care were that related to the
law, policy, and ethics
Relative to the mentioned legislations and policies, the shortfalls in patient safety and care
included the following:
Based on the outcome four of the report, the shortfall included the poor quality of service that
was being provided to the patients. This was because; the information quality so recorded based
on the operation of the care plans was extensively poor. Additionally, the information sheet was
essentially not person-centric and the staffs were poor in understanding the complex needs
associated with individual patients. This affected their serviceability as well as response to
negative events (Fabian et al., 2015). Additionally, the staffs kept a poor record of injuries that
occurred to the patients as well as exhibited poor quantum wound management mechanisms.
Based on outcome seven of the report, the management had not reposed effectively and
efficiently to the multiple allegations of abuse that had occurred or had the potential to occur in
the long end. As a result, individuals were protected poorly from potential abuse in the hands of
the employees or from other patients, as the top floor houses individuals detained in the Mental
Health Act. Hence, legislations that were breached in this segment include the Human Rights
Act, the Controlled Drugs Act, and improving healthcare quality through professional
development by others (Isaacs, 2016).
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Based on outcomes of nine to fourteen, patient safety was compromised as the organisation had
failed to obtain, record, handle the safe administration and disposal of medicines post their usage
or expiry. Legislation that was breached in this segment included The Mental Capacity Act, the
Health and Social Care Act, Quality Care Commission Regulations and others.
Explain what was the outcome of not following the laws and policies in place (what
happened to winterbourne, the service users and staff and what recommendations were
made)
Post the publication of the CQC report, the organisation was subjected to multiple outcomes.
These outcomes could be segmented into the actual happening to the organisation, impact on the
staff and the service users and recommendations made by the CQC on the operations and the
services of the organisation.
Based on the segment of the organisation, it was barred by the CQC to admit any patient or
individual into the service being provided by them. This had come into effect on the 13th of May
of 2011. The reason for the same included reduction in the potential risk of abuse and poor health
care treat of persons with learning difficulties. However, the most significant outcome that the
organisation had to face includes removal of the Vantage Park location as a service provider
located in an enforced manner (Cqc.org.uk, 2019). As a result, the organisation would not be
able to continue providing services in the mentioned locations as well as no chance of appeal
against the mentioned enforcement.
Based on the service users and staff, the outcome included the suspension of 15 staff of the
organisation and cease of new recruitments. The organisation had to make a temporary
arrangement for the continuation of existing services. The service users, however, provided a
positive report of one to one relationship (Dickinson, 2019).
Additionally, post the successful conduction of the quality inspection the following were
recommended to the organisation:
 Individuals should be given required medicines in a safe way and ineffective manner
 Patients should be cared for by the individuals that are respectively qualified and able to
do their job
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 Staff should be extensively trained and supervised in a regular manner
 Services provided should have quality checking mechanisms and systems for risk
management and parameters assessments
 Notification of incidents to NHS and the patient party including death intimation of
individuals admitted under the Mental Health Act
Critically review the ways in which workers at winterbourne could have ensured compliance with the relevant legislation and national policies through ethical
practice
Through the ethical practice, workers could have undertaken multiple ways for the extensive compliance of the mentioned legislation as well as national policies. The
multiple practices would include the following:
 Performing a personal SWOT analysis
 Demanding standard protocols from the management for the execution of the task
 Adhering to process taught by the education providers in the segment of health and social care
 Using digital technology like database management system and employee relationship management to identify potential negative attributes of employees
Performing a SWOT analysis would enable the workers to identify the area in which one would excel in the long end. This would reduce frustrations in working with
mentally disturbed or poor communication individuals. As a result, the probability of abuse would reduce. However, a personal SWOT analysis would be limited in the
overall segment as it organisational benefits and improvement could not be identified using SWOT (Bull et al., 2016). However, demanding protocols would enable the
workers to execute their task in a more efficient manner. However, limitation to the same would include ethical conflicts as health care is dependent on the situation
and dealing with the books would reduce variations (Van Rossum et al., 2016). All the mentioned practice could have been effectively incorporated within the
organisation by using digital technology like DBMS and analytical modules. This would be because, the DBMS would have enabled the organisation to maintain
individual records and conduct high-quality analysis to identify the pattern of needs of the patients (Dziedzic et al., 2016).
Analyse the impact that different equality legislation and equity has when safeguarding individuals in relation to Winterbourne view
Multiple interpretations of the equality legislation could be analysed to understand the impact of the same in safeguarding the individuals.
In the segment of the Human Rights Act, it could be deduced that in the event that all of the provisions were adhered to, the organisation would have multiple positive
results from the same. First, the issue of abuse could have been reduced largely. This would be because workers having knowledge of human rights would have not
abused the patients and used extensive caution while dealing with waste disposal and wound management. Second, the organisation would then be able to develop
multiple frameworks and standard operating procedures for the treatment of patients (Stein, 2017). This would be because to treat all patients in a fair manner, a
standardised protocol would be required for operations and resource management.
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In the segment of Equality Act of 2017, adherence to the same would enable the organisation to cater to a regular workforce for the conduction of services and
operations. Hence, relative to the safeguarding the individuals, adherence to this act would have reduced the need for suspending the 15 employees. In the long end, this
would have lead to the development of a close relationship between the workers and the patients. As a result, any difficulty in service or any particular interest could
then be communicated to the staff than to the family members. However, the negative impact on the safeguarding of the individuals would be mostly in the reduction of
effort by the workers to understand the needs of the patients. This would be because; having the same set of staff for a prolonged manner may lead to passive working
among them. As a result, the workers would be most concerned with meeting the daily requirements and not caring for the patients admitted due to either mental ill
health or learning disabilities (Bruley et al., 2018).
Describe the relationship between law, policy, and ethics in relation to the practice that was
demonstrated at Winterbourne
The sole motive of any law or policy or even ethics in any domain lies in providing a framework
for conduction of positive operations in a particular segment. Hence, based on the practice that
was demonstrated at Winterbourne, it could be deduced that the relationship with the law, policy,
and ethics was an inverse one. This would be due to two-three reasons. First, BBS Panorama
reported multiple cases of abuse in the hospital (BBC News, 2019). This violated the basic
ethical treatment that is provided to the care users. Additionally, ethics in social and healthcare
included having open communication with the patients as well as the guardian of the patients.
However, such practices were not present entirely in the organisation. Evidence for the same
could be found on the recommendations provided by the CQC.
Second, the organisation essentially breached multiple aspects of the social and health care act as
well as the human rights act. Evidence for the same includes identification of no standard
protocol of medicine administration and disposal. This directly violated provisions of health care
act as well as recommendations of the NHS England. Additionally, inverse relationship with the
health care policy includes poor adherence to human rights acts as well as CQC
recommendations.
Compare national and organisational policies against the national professional standards
and how they affect practice in health and social care
National
Standards
National policy Organisational policy The effect of health and
social care
Using Developing Organisational policy in a This difference essentially
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Consolidated-
Clinical
Document
Architecture
(C-CDA)
medical
documents that
could be read by
humans in
general form and
by machine
through XML
general form includes the
development of such report
in word text or portable
document format and
maintaining analytical data
in excel, MS Access or Big
Data in case of extensive
quantum of patients.
However, based on the
provided organisation, MS
Excel and Access would be
taken into consideration due
to low bed capacity and data
generation.
affects the storage and
maintenance of
demographic and medical
data so developed by the
service providers. Overall,
this difference would
create a positive change in
the organisational policies
and current advancement
in digitisation would be
taken into consideration
for effective treatment
(Blavin et al., 2017).
Having a
certified care
manager
Ensuring only
certified health
care managers in
each department
for an
organisation
The organisational policy
includes incorporating one
certified manager in an
overall segment and using
qualified and experienced
individuals to fill other
managerial or backend
positions.
Having a mix of certified
and experienced managers
would enable the effective
deployment of social care
as theory and practical
approach would be
integrated. This would
lead to extensive
adherence to regulations.
Adhering to 7
Principles of
healthcare
ethics
Incorporating all
principles of
healthcare ethics
Incorporating 7 principles
of healthcare ethics and 4
principles of medical ethical
ethic
Incorporating the
principles of autonomy,
justice, beneficence, and
non-malfeasance would
increase the efficacy of the
services as well as
improve overall efficiency
(Cathy and Flite, 2014).
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Table 1: Comparison of standards and policies
Conclusion
This sectional study could be concluded with two statements. First, it could be concluded that all
the mentioned regulations and frameworks are provided to an organisation to improve the
operational efficiency in the long end. This would be because all the mentioned legislation has
been recommended and developed post extensive analysis in the segment. Second, it could be
concluded that Winterbourne View projected mostly poor management practices in the health
and social care. This would be because all the observations undertaken by the CQC was a result
of the poor management control in health and social cares.
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