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Your healthcare practice

NNCO_HCA Introducing practical healthcare


of 74 27th February 2019

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Contents Introduction Learning outcomes 1 Privacy and dignity 2 Fluids and nutrition 3 Health and safety in your workplace

3.1 Infection prevention and control 4 Basic life support 5 Awareness of mental health, dementia and

learning disability What you have learned in this section Further information (optional) Section 3 quiz References Acknowledgements





IntroductionWelcome to Section 3 of the Introducing practical healthcare

course, where you will explore a number of concepts regarding

healthcare practice. When completed you will have the opportunity

to obtain a ‘Your healthcare practice’ badge. This section will take

approximately 3 hours to complete.

Here you will consider the privacy and dignity of patients, with a

particular focus on how to provide intimate care for those who are

ill (for example, the bedridden or in hospital). You will learn about

the importance of fluids and nutrition, and a number of important

factors to consider when trying to maintain a healthy diet for the

patient.

Another important part of this section is about how to maintain

health and safety within your workplace, and the need for infection

prevention and control, covering hand hygiene, safe disposal of

waste, safe management of laundry, and Personal Protective

Equipment (PPE) such as masks and goggles to protect from

injury and infection. Lastly, this section of the course will aim to

raise your awareness of mental health, dementia and learning

disabilities, by providing definitions and specific types to look out

for so that you can respond in the most appropriate way.





Learning outcomesBy completing this section and the associated quiz, you will be

able to:

explain why it is important to respect privacy and

dignity in personalised care

demonstrate awareness of health and safety

regulations at work.





1 Privacy and dignityIn order to deliver good healthcare and support, you must practise

two important values: privacy, which means giving someone space

where and when they need it, and dignity, which means focusing

on the value of every individual. To achieve this you must respect

their views, choices and decisions; enable them to be as

independent as possible; not make assumptions about how they

want to be treated; always work with care and compassion; and

communicate as directly as you can with them.

In the next audio clip you can clearly hear how much Gail (a

healthcare assistant) loves her job, and how she always works

with utmost compassion for her patients.

Audio content is not available in this format.

A healthcare assistant who loves her job

View transcript - A healthcare assistant who loves her job

You should always provide personalised care and support that

puts an individual at the centre of their care. When you first meet a

new patient you should tell them your name and what your role is,

and ask them what they want you to call them. Becoming ill usually

has an adverse effect on people, whatever their age or

background. Patients are likely to be worried about the unknown,





so remember that your patient may well be experiencing fear of

what lies ahead, and applying these values will go some way to

reassuring them and enable them to be as independent as

possible (Skills for Care, 2015, p. 2).

Good personal hygiene is an important part of maintaining dignity.

Providing intimate care can be a particular challenge for newer

healthcare assistants. Bodily functions like washing, dressing and

toileting are normally kept very private, and might seem difficult

because of cultural or personal background, gender issues and

social awkwardness. Most inpatients expect to maintain their

normal standards of hygiene – and this should be recorded on

their care plan. You should always enable the patients to do as

much as possible for themselves, but they may need help to wash

and you should be aware that they may be feeling embarrassed or

humiliated by being needy in this way. Whether using the

bathroom or washing a patient in bed, you will need to ensure the

water temperature and depth of the bath water are appropriate,

and whilst making sure the person’s dignity is protected, end up

with them being clean and refreshed. Careful attention to

cleanliness of the mouth and feet is also important, by giving

attention to these details it shows a patient that you are really

doing your best to make them as comfortable as you can.





Figure 1 Bathing someone is an intimate task which falls outside the usual

social conventions

View description - Figure 1 Bathing someone is an intimate task which falls outside the usual social ...

Activity 1Allow about 15 minutes

Listen to the following podcast which focuses on a busy ward and

the need to provide care and compassion when working with

patients. The first voice you hear is that of Ann, a healthcare

assistant. While you are listening, think about the following points

and make notes in the box below:

What do healthcare assistants do within the ward?





What sort of issues do they describe?

What elements of good person-centred care are

listed?

If already working in healthcare, do you have to

consider similar levels of privacy and dignity within

your own role?


A day in the life of a hospital ward: working with patients

View transcript - A day in the life of a hospital ward: working with patients

Provide your answer...

View comment - Untitled part





2 Fluids and nutritionAccording to the UK Food Standards Agency (FSA), a normal

balanced diet should include about one-third fruit and vegetables,

and one-third bread, rice, potatoes, pasta and other starchy foods

(carbohydrates). The remaining third of the diet should be made up

of about equal quantities of meat, fish, eggs and beans (sources of

protein) and of milk and dairy foods, with ideally only a small

amount of foods and drinks that are high in fat and/or sugar. This

is illustrated in the FSA’s ῾eatwell plate᾿ (Brown, 2010).

Figure 2 The Food Standards Agency's 'eatwell plate' (FSA, 2010)

View description - Figure 2 The Food Standards Agency's 'eatwell plate' (FSA, 2010)





People who are ill particularly need fluids and nutrition to help

them get better, and as a healthcare assistant maintaining

appropriate levels of these in accordance with patients’ care plans

will form a major part of your day-to-day work. Caring for patients

who find eating and drinking difficult can however pose a big

challenge for healthcare staff, and recent reports have shown

evidence of severe problems in this area.

Nutrition is more than calories; our diets must be balanced and

contain a range of vital nutrients which are important to remember.

Some medical conditions will require a diet which is high or low in

some of them. These nutrients include:

carbohydrates for energy

protein for body repair

fibre to help our digestion and remove waste products

minerals for our bones, teeth, blood and nerves;

vitamins to regulate many of the body’s systems and

functions (OpenLearn, 2011).

It might seem that patients in hospital would need less food than

normal, because they’re less active, and this is true for some but

not all. Many people are underweight when they come for

treatment or admitted to hospital and need building up, whereas

other people with excess weight may be encouraged to lose some

pounds, for example, if they have heart disease or arthritis.





Patients may need a full diet or a light diet, high calorie or low fat,

or low carbohydrate if they are diabetic, and all food requirements

will form part of their care plan once an assessment has been

made about their nutrition and hydration. The healthcare assistant

might be required to help patients choose their meals from a

menu, and in other cases make appropriate choices on their

behalf. It would also be an important part of your role to observe

any ‘nil by mouth’ instruction, for example, for patients going to the

operating theatre.

It is essential that patients maintain a good level of fluid intake

(hydration). Water is the most important aspect of our diet because

we can’t manage without daily supplies, and fluid losses must be

replaced quickly to avoid long-term damage, for example, to the

brain and vital organs. The body only has a small reserve of water,

and a lack of liquid intake (dehydration) results in weakness,

headaches, tiredness and loss of concentration, followed by

collapse and eventually death. Water losses through urine, from

the skin, from breath and in faeces average about two litres per

day, and they must be replaced (OpenLearn, 2016).

You may be aware of instances where patients did not receive

enough hydration or nutrition which can result in devastating

results:





'Dehydration contributes to the death of more than 800

hospital patients every year. Another 300 die

malnourished̓' (Daily Mail , 2011 ) Lydia Spilner (100 years old) passed away from renal

failure caused by dehydration (The Guardian , 2013).

Activity 2Allow about 15 minutes

There are a number of factors to be considered when supporting

patients to eat and drink, as well as understanding about food

requirements for certain medical conditions. Think about whether

the food tray is within their reach. Is the temperature of their food

suitable? Did they receive what they wanted, and if not, are there

alternative options? As you have seen, it is important to consider

the patients’ needs when offering nutrition and fluids.

Consider the situations below and ask yourself how you would

help or what factors would be relevant for each patient.

1. Does your patient have arthritis in the hands?



2. Does your patient have raised blood cholesterol levels?




http://www.theguardian.com/society/2013/jun/05/hospital-apologises-woman-dies-dehydration


http://www.dailymail.co.uk/health/article-1390925/Elderly-patients-dying-thirst-Doctors-forced-prescribe-drinking-water-old-alive-reveals-devastating-report-hospital-care.html




3. Is your patient diabetic?



4. Does your patient have high blood pressure?



5. Is your patient obese?



6. Does your patient have a visual impairment?



7. Does your patient have dementia?



8. Has your patient had a stroke? of 74 27th February 2019






(Adapted from Skills for Care (2015b) Workbook 8, Fluids and Nutrition)

Figure 3 Hospital food needs to be in accordance with the patient’s

assessed care plan

View description - Figure 3 Hospital food needs to be in accordance with the patient’s assessed care ...

Activity 3 Allow about 15 minutes





Listen to the next audio podcast about a lady living with a visual

impairment. She talks about the support she needed with eating

and drinking.

Having listened to the audio podcast, write down some notes

about how you would encourage a patient with a visual impairment

to eat and drink.

This audio is provided for use within the course only.


Support with eating and drinking

View transcript - Support with eating and drinking


View comment - Activity 3

It is very important as a healthcare assistant to understand what a

vital role fluids and nutrition play in patient care and recovery:

wherever you work, and so you are likely to be involved in

assisting patients with food and hydration each and every day.





3 Health and safety in your workplaceThe Health and Safety Executive (HSE) requires employers to

have a health and safety policy which sets out how they will protect

everyone in their workplace, including employees, visitors,

contractors and any individuals who access services. Your

awareness and practice of health and safety will contribute to a

safety culture at work. Accidents have causes, and steps must be

taken to prevent them otherwise accidents will continue to happen.

In Section 2 you were introduced to the '6 Cs' set in place by NHS

England (2012): Care, Compassion, Competence,

Communication, Courage and Commitment. Competence ensures

that you are keeping the individuals you support as safe as

possible; only undertaking certain activities once you are

competent to do so. Your workplace will have Health and Safety

Representatives who are the key 'watchdog' on behalf of workers

to ensure employers provide a safe and healthy workplace. Health

and Safety Representatives have a legal right to carry out regular

inspections and to be consulted by the employer over risk

assessments and accidents or incidents at work.

The Health and Safety Executive identifies a number of health and

safety risks for workers. They include:





slips and trips in the physical environment caused

by uneven floors, spilled liquids, poorly lit or unlit

areas, trailing cables and wires, and so on

musculoskeletal disorders, that is, sprains,

strains and pains from lifting, carrying, pushing,

pulling, reaching, repetitive movements, and so on

stress, for example, from too much work, too many

demands, conflicting demands or excessive pressure

of any kind.

Figure 4 The physical environment can cause slips and trips (left); activities

at work can cause musculoskeletal disorders (centre); people can experience

work-induced stress (right)

View description - Figure 4 The physical environment can cause slips and trips (left); activities at ...

Now you can listen to Gail talking about some real examples of

health and safety in the workplace, and what sort of incidents or

accidents might occur.






Health and safety on the ward

View transcript - Health and safety on the ward

3.1 Infection prevention and controlAs a healthcare assistant you must practise in a way that keeps

the risk of transferring infection to a minimum, whether from

yourself to patients or between patients. Infections and infectious

diseases are caused by harmful germs, also called pathogens,

such as bacteria and viruses. Most pathogens are so small that

they cannot be seen without a microscope, but they are all around

us.

There are a number of things you must do to prevent infections

from spreading:

prepare food safely

carry out good hand hygiene

make sure all equipment is cleaned properly

dispose of waste safely

manage laundry safely

use personal protective equipment

don’t go into work if you have an infectious illness.

Safe food preparation of 74 27th February 2019




Micro-organisms can live in food, and certain raw foods will need

to be cooked to remove them. Before handling and/or preparing

food, you should remove jewellery and wash your hands

thoroughly. Equipment should be washed in hot soapy water

between uses. Ensure food is cooked thoroughly and that food

stored in a fridge is labelled, dated and kept at 5°C. Raw and

cooked foods should be prepared separately. Check what

precautions are taken within your workplace to ensure food poses

minimal risk to your patients.

Good hand hygieneThe National Institute for Health and Care Excellence (NICE)

describes five points when health and social care workers should

clean their hands (NICE, 2012). These are:

immediately before every episode of direct patient

contact or care, including aseptic [cleaning]

procedures

immediately after every episode of direct patient

contact or care

immediately after any exposure to body fluids

immediately after any other activity or contact with a

patient's surroundings that could potentially result in

hands becoming contaminated

immediately after removal of gloves.





In addition, NICE (2012) defines an effective handwashing

technique as involving the following three stages: ‘preparation,

washing and rinsing, and drying. Preparation requires

wetting hands under tepid running water before applying liquid

soap or an antimicrobial preparation. The handwash solution must

come into contact with all of the surfaces of the hand. The hands

must be rubbed together vigorously for a minimum of 10–15

seconds, paying particular attention to the tips of the fingers, the

thumbs and the areas between the fingers. Hands should be

rinsed thoroughly before drying with good quality paper towels.’

Figure 5 Frequently missed areas of hand washing





View description - Figure 5 Frequently missed areas of hand washing

When hand-washing you should remove your wristwatch and any

jewellery on your hands and lower arms, and wash right up to your

elbows, paying particular attention to your thumbs and the space

between your fingers, areas which are commonly missed. It is also

important to ensure that fingernails are clean (without nail varnish)

and kept short. Remember to make use of alcohol gels supplied

within your setting, and to cover any cuts you have on your hands

with waterproof dressings to avoid cross-infection.

Safe disposal of wasteClinical waste is any waste which consists of:

human or animal tissue

blood or other body fluids or excretions

drugs or other pharmaceutical products

swabs or dressings

syringes, needles, blades (stitch removers) or other

sharp instruments

Any of these could cause harm to a person coming into contact

with it, and so hazardous waste must be disposed of in a way that

avoids any danger or harm to yourself or other members of staff.

Your workplace will have a policy about this.





Figure 6 Special bins are provided for clinical waste in healthcare settings

(left; this one shows the international symbol for biological hazard); sharps

boxes are also provided for the safe disposal of sharp instruments (right)

View description - Figure 6 Special bins are provided for clinical waste in healthcare settings (left; ...

Safe management of laundryLinen that comes into contact with workers or individuals can

become contaminated with harmful micro-organisms and should

be washed separately from other items. Soiling is likely to include

blood and tissue, sputum (a mixture of saliva and mucus), urine,

vomit and faeces. Personal protective equipment (PPE) must be

worn when handling infected linen as it can transfer germs to skin

and clothing. Uniforms or work clothing should be changed daily





and washed on a hot wash, then tumble-dried or hot ironed, to kill

any bacteria present.

Correct use of personal protective equipment (PPE)The most common PPE you will use as a healthcare assistant are

disposable aprons, gloves and masks, all of which will be for

single-use only. Disposable aprons protect clothing and uniforms

from contamination from blood and body fluids, and you should be

issued with enough uniforms for regular changing. Gloves play an

important role in protecting workers from exposure to blood-borne

viruses, especially where there is a risk of injury such as a

puncture wound with contaminated sharps, abrasions or cuts.

Masks protect you from breathing in harmful micro-organisms, and

eye protection and face shields should be worn if there is a risk of

being splashed with body fluids.





Figure 7 Personal protective equipment will protect you from contamination

from blood and other body fluids

View description - Figure 7 Personal protective equipment will protect you from contamination from blood ...


The law says that individuals should be provided with the correct

materials and equipment to protect them from injury and, as far as

possible, from the risk of infection while at work. If appropriate,

think about occasions when you have had to wear or use PPE at

work. Write down in the space below what type it was and why you

had to use it.



Infectious illnessIf you have cold or flu symptoms (such as coughing or runny

nose), an upset stomach or skin infections, you should speak to

your manager before reporting for work. If you have diarrhoea or

vomiting you should not attend work until you have been free from

symptoms for 48 hours.





Good hygiene is important for everybody, but as a healthcare

assistant you have a duty to adopt these safe measures for your

own and others’ safety.





4 Basic life supportThe principles of basic life support, or first aid, are to save life by

removing danger, to treat urgent symptoms and to prevent

extension of injuries. You also need to avoid doing harm by

carrying out treatment which you are not trained to do. Your

employer should provide basic life support training. All workplaces

will have a health and safety procedure to outline what to do in an

emergency, and you must ensure that you are familiar with it. You

must also be familiar with your patients’ care plan, for example if

they are known to have any condition that could lead to sudden

illness (such as a diabetic coma, or an epileptic fit), and how you

should respond.





Figure 8 Putting a casualty into the recovery position

View description - Figure 8 Putting a casualty into the recovery position





5 Awareness of mental health, dementia and learning disability Around one in four adults has at least one mental health need at

any time, and in the next 20 years the number of British people

expected to suffer from dementia will grow by 40 per cent. Even

though you might not be working in a setting specifically caring for

people with mental health conditions, dementia and learning

disabilities, it is still important to have some awareness of the signs

and symptoms. This will help you to show compassion and care

when you observe any behaviour that seems unusual or difficult to

understand, and to be aware of the need to consult more

experienced staff about behaviours if necessary.


The next video will raise your awareness of the needs of people

with dementia. It explains certain features of the public space of a

residential home especially designed for people with dementia. As

you watch it, write down any points about the design that make life

easier for the residents.

This video is provided for use within the course only.

Video content is not available in this format.





The Lodge: public space

View transcript - The Lodge: public space



The three most common types of mental health problem that you

might encounter in your role are:

1. depression: a common mental disorder that causes

people to experience depressed mood, loss of interest

or pleasure, feelings of guilt or low self-worth,

disturbed sleep or appetite, low energy, and poor

concentration, which can be mild or very severe

2. anxiety: when people cannot control their worries

3. dementia: a decline in mental ability which affects

memory, thinking, problem-solving, concentration and

perception. This includes Alzheimer’s disease and

vascular dementia.

You are probably less likely to encounter psychosis, which is

when a person interprets events differently from those around

them, including experiencing hallucinations, delusions or flight of

ideas (MIND, 2015). It is less common and might be part of

bipolar disorder (a mood disorder also known as manic

depression) or schizophrenia (a psychotic disorder where





people interpret reality abnormally). You might also meet patients

who have a learning disability, which is where people have a

significantly reduced ability to understand new or complex

information and to learn new skills (Department of Health, 2001).

If you think that someone is developing symptoms of a mental

health problem or dementia, or if you think that the support needs

associated with their learning disability need reassessing, you

should record this information and pass it on. Who you inform and

how will depend on your workplace guidelines and your role. For

more information on mental health, dementia or end of life care,

visit the short course for carers entitled ‘Caring for adults’.

Case study: LynneLynne has been managed by mental health services for many

years with a diagnosis of bipolar disorder, and it has been

extremely important to her to have access to the right

professionals and support throughout this time. She has been

fortunate in having a consistent social worker contact to help her

through, who stays in touch with her on a regular three-weekly

basis. They have grown to know each other well and have

developed a supportive relationship. A similarly supportive

relationship with her consultant has allowed for consistency of care

and an understanding of her history. Lynne says that maintaining a

line between the professional and patient, whilst having mutual




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respect and understanding of each other has been an important

feature of her care. Lynne also described being treated with dignity

and being allowed to grow, rather than feeling restricted by her

mental health issues. During one of her bouts in hospital with

depression she gained great confidence from leading a group. This

is a good example of a long-term mental illness being managed

effectively whilst living largely in the community through person-

centred care.





What you have learned in this section You should always provide personalised care with due

attention to the patient’s privacy and dignity.

Fluids and nutrition will form a major part of your day-

to-day work and some individuals might experience

difficulties in eating or drinking without help.

You must observe various health and safety

regulations in your workplace including how to prevent

infection.

It is helpful in your role to understand the basics of

mental health conditions, dementia and learning

disabilities.





Further information (optional)If you are interested in learning more about some of the mental

health issues described here, the following free course is available

on OpenLearn: ‘Understanding depression and anxiety’

For more information on mental health, dementia or end of life

care, visit the short course for carers entitled ‘Caring for Adults’.




http://www.open.edu/openlearnworks/course/view.php?id=2171

http://www.open.edu/openlearn/health-sports-psychology/health/understanding-depression-and-anxiety/content-section-0


Section 3 quizWell done, you have now reached the end of Section 3 of the

Introducing practical healthcare, and it is time to attempt the

assessment questions. This is designed to be a fun activity to help

consolidate your learning.

There are only five questions, and if you get at least four correct

answers you will be able to download your badge for the ‘Your

healthcare practice’ section (plus you get more than one try!).

I would like to try the Section 3 quiz to get my badge

If you are studying this course using one of the alternative formats,

please note that you will need to go online to take this quiz.

I’ve finished this section. What next?You can now choose to move on to Section 4, Duty of care, or to

one of the other sections so you can continue collecting your

badges.

If you feel that you’ve now got what you need from the course and

don’t wish to attempt the quiz or continue collecting your badges,

please visit the Taking my learning further section, where you




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can reflect on what you have learned and find suggestions of

further learning opportunities.

We would love to know what you thought of the course and how

you plan to use what you have learned. Your feedback is

anonymous and will help us to improve our offer.

Take our Open University end-of-course survey.




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ReferencesBrown (2010). Feeding The Chilean Miners [Online]. Available

at www.open.edu/openlearn/body-mind/health/feeding-the-chilean-miners (Accessed 7 December 2015).

Daily Mail (2011). 'Elderly patients dying of thirst: Doctors forced

to prescribe drinking water to keep the old alive, reveals

devastating report on hospital care' [Online]. Available at

www.dailymail.co.uk/health/article-1390925/Elderly-patients-dying-thirst-Doctors-forced-prescribe-drinking-water-old-alive-reveals-devastating-report-hospital-care.html (Accessed 7 December 2015).

Debgroup.com. (2015). Improper Hand Washing. [Online].

Available at

www.debgroup.com/uk/learning-zone/handwashing-technique/poor-hand-washing (Accessed 7 December 2015).

Department of Health. (2001). Valuing People: a new strategy for learning disability for the 21st Century. London:

Department of Health. [Online]. Available at

www.gov.uk/government/uploads/system/uploads/attachment_data/file/250877/5086.pdf (Accessed 7 December 2015).




https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/250877/5086.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/250877/5086.pdf

http://www.debgroup.com/uk/learning-zone/handwashing-technique/poor-hand-washing

http://www.debgroup.com/uk/learning-zone/handwashing-technique/poor-hand-washing




http://www.open.edu/openlearn/body-mind/health/feeding-the-chilean-miners

http://www.open.edu/openlearn/body-mind/health/feeding-the-chilean-miners


The Guardian. (2013). 'Hospital apologises after 100-year-old

woman dies of dehydration'. [Online]. Available at

www.theguardian.com/society/2013/jun/05/hospital-apologises-woman-dies-dehydration (Accessed 7 December

2015).

MIND. (2015). Psychotic experiences. [Online]. Available at

www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/about-psychosis/?o=6264#.Vk3b5ksny00 (Accessed 7 December 2015).

NHS England. (2012). Our Culture of Compassionate Care.

Redditch: NHS England. [Online]. Available at

https://www.england.nhs.uk/6cs/wp-content/uploads/sites/25/2015/03/introducing-the-6cs.pdf (Accessed 7 December

2015).

NICE (2012). Healthcare-associated infections: prevention and control in primary and community care. [Online]

Available at

www.nice.org.uk/guidance/cg139/chapter/guidance

(Accessed 29 January 2016).

OpenLearn (2015) Hydration: Water and sports drinks, 'Eating

to win: activity, diet and weight control' [Online]. Available at

www.open.edu/openlearn/health-sports-psychology/health




http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-win-activity-diet-and-weight-control/content-section-5

https://www.nice.org.uk/guidance/cg139/chapter/guidance

https://www.england.nhs.uk/6cs/wp-content/uploads/sites/25/2015/03/introducing-the-6cs.pdf

https://www.england.nhs.uk/6cs/wp-content/uploads/sites/25/2015/03/introducing-the-6cs.pdf

http://www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/about-psychosis/?o=6264#.Vk3b5ksny00






/sport-and-fitness/eating-win-activity-diet-and-weight-control/content-section-5 (Accessed 7 December 2015)

Skills for Care (2015) The Care Certificate Standard 7 workbook [Online]. Available at

www.skillsforcare.org.uk/Document-library/Standards/Care-Certificate/Standard%207%20CC%20Workbook.pdf (Accessed 7 December 2015)

Skills for Care (2015) The Care Certificate. Workbook 8, Fluids and Nutrition. Leeds: Skills for Care. [Online]. Available at

www.skillsforcare.org.uk/Document-library/Standards/Care-Certificate/Standard%208%20CC%20Workbook.pdf (Accessed 7 December 2015).

Skills for Care (2015) The Care Certificate. Workbook 13, Health and Safety. Leeds: Skills for Care. [Online]. Available at

www.skillsforcare.org.uk/Document-library/Standards/Care-Certificate/Standard%2013%20CC%20Workbook.pdf (Accessed 7 December 2015).

Skills for Care (2105), The Care Certificate, Workbook 15, Infection Prevention and Control [Online]. Available at

www.skillsforcare.org.uk/Document-library/Standards/Care-Certificate/Standard%2015%20CC%20Workbook.pdf




http://www.skillsforcare.org.uk/Document-library/Standards/Care-Certificate/Standard%2015%20CC%20Workbook.pdf











OpenLearn (2011) ‘Section 1: A balanced diet’, Obesity: balanced diets and treatment [Online]. Available at

www.open.edu/openlearn/science-maths-technology/science/biology/obesity-balanced-diets-and-treatment/content-section-1.1 (Accessed on 7 December 2015)

The Open University (2015) K101 Learning Guide 16: Promoting healthy, safe and caring practice, Milton Keynes,

The Open University.

UK Food Standards Agency (2010). Using the Eatwell plate.

[Online]. Available at

https://www.nhs.uk/tools/documents/eatwell/eatwell.html (Accessed 7 December 2015).




https://www.nhs.uk/tools/documents/eatwell/eatwell.html

http://www.open.edu/openlearn/science-maths-technology/science/biology/obesity-balanced-diets-and-treatment/content-section-1.1




AcknowledgementsThis free course was written by Joanne Thomas (consultant for the

Open University) and Emma Lipscombe (Learning and Workforce

Development Officer for UNISON), with contributions from Ruth

Beretta (staff tutor for the Open University).

Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence.

The material acknowledged below is Proprietary and used under

licence (not subject to Creative Commons Licence). Grateful

acknowledgement is made to the following sources for permission

to reproduce material in this free course:

Every effort has been made to contact copyright owners. If any

have been inadvertently overlooked, the publishers will be pleased

to make the necessary arrangements at the first opportunity.

FiguresFigure 1: © Ace Stock Ltd/Alamy

Figure 2: Food Standards Agency (http://www.food.gov.uk/)

Figure 3: © Nano/iStockphoto.com of 74 27th February 2019



http://www.food.gov.uk/




http://www.open.ac.uk/conditions

http://www.open.ac.uk/conditions


Figure 4: (left) © iStockphoto.com/baona; (centre) ©

iStockphoto.com/kutaytanir; (right) ©

iStockphoto.com/PeopleImages

Figure 5: © unknown

Figure 6: (left) © dblight/iStockphoto.com; (right) © David

FR/iStockphoto.com

Figure 7: © sturti/iStockphoto.com

Figure 8: © highway starz-photography/iStockphoto.com

Audios‘A healthcare assistant who loves her job’ including transcript:

courtesy Unison (https://www.unison.org.uk/)

‘A day in the life of a hospital ward: working with patients’ including

transcript: © The Open University

‘Support with eating and drinking’ including transcript: © The Open

University

‘Health and Safety on the ward’ including transcript: courtesy

Unison (https://www.unison.org.uk/)

Video




https://www.unison.org.uk/

https://www.unison.org.uk/


Video ‘The Lodge: public space’ including transcript: © The Open

University





Activity 1Untitled partCommentYou may have written that healthcare assistants help patients to

get up, wash and dress, do their hair, make beds and serve food

or help people eat. Healthcare assistants also help patients to use

the toilet and move around if they find it difficult. It is important to

make the time to talk to patients, especially when they are upset,

to help them feel less anxious. Also, listening to what the patient

and their family want is important, and ensuring that they are kept

well-informed. Treating patients with respect and kindness is vital:

all of these are giving care in a person-centred way.

Back to Session 1 Part 1





Activity 2Untitled partCommentThey may need help with cutting up food or opening packs of food.

Avoid offering foods that are restricted within the patient’s diet:

a. a Muslim would require halal meat and no pork

b. patients on statins should not eat grapefruit

c. a vegetarian does not eat meat or fish, and if they are

vegan their diet contains no dairy products at all.






Activity 2Untitled partCommentThey may be advised not to have too much saturated fat such as

butter, fried items and pastry






Activity 2Untitled partCommentThey will be advised to avoid too much sugar, found in sweets,

chocolate, sugared breakfast cereals, cakes and puddings.






Activity 2Untitled partCommentThey may be advised to limit salt.






Activity 2Untitled partCommentThey should be encouraged to limit sugary and fatty foods.






Activity 2Untitled partCommentIt may affect the way they see their food, in which case they would

require some sort of aid such as a magnifier over their bowl or

plate which should be fixed so that it cannot move around.






Activity 2Untitled partCommentThey may be forgetting to eat. Remind them at regular intervals to

eat, and note down when they eat a meal.






Activity 2Untitled partCommentIt may have affected the muscles around their mouth for chewing,

or hands for lifting drinks. They may require food to be pureed or

provided as soft, smaller portions in order to support their chewing.

They may need to be helped to lift drinks, or help to position forks

and spoons to their mouth.






Activity 3 CommentYou might have said that you need to know your patient as an

individual so that you’d be aware if any psychological issues are

preventing them from eating (e.g. loss of dignity and independence

at needing to be fed by someone else, or feeling depressed and

getting no enjoyment from food), or whether the issues are

practical and they physically can’t see the food (the lady speaking

describes the importance of a healthcare assistant explaining what

types of food are on the plate, and their positioning using a clock-

face approach.) Or if she cannot see where the cutlery is you

would need to hand it to her. Also she might lack the strength to lift

the spoon to her mouth or simply have no appetite.

Back to Session 2 Activity 2





Activity 4 CommentIf you already work as a healthcare assistant, there must be

numerous times you’ve had to wear PPE: for example disposable

aprons when bathing a patient, gloves when changing dressings

and masks for surgical procedures. What does it feel like to wear

PPE, and how does it make patients feel when cared for by

someone wearing it?






Activity 5 CommentThe building design is triangular and is based on evidence from

research that people with dementia don’t do well in closed spaces,

therefore it has features such as wide and well lit corridors which

are a good place to walk if a resident is agitated, and in the centre

is an open-plan garden space. To help the residents recognise

rooms, the toilet doors are all painted bright yellow but all of their

front doors are painted different colours. The dining area has a

wooden floor and the carpets are plainly coloured without patterns.

The market square is good for people getting together and the

whole area gives greater independence for residents, but is

designed in such a way so that staff can still keep an eye on them.






Figure 1 Bathing someone is an intimate task which falls outside the usual social conventions DescriptionThe picture shows a female healthcare assistant assisting an elderly male patient who is sitting in a bath. The healthcare assistant is looking directly at the patient and holding his right hand, whilst touching him reassuringly on the shoulder.

Back to Session 1 Figure 1





Figure 2 The Food Standards Agency's 'eatwell plate' (FSA, 2010)DescriptionThe picture shows a graphical representation of a plate with a knife and fork alongside. The plate has been divided into five segments, each showing different types of food as follows: one third for bread, rice, potatoes, pasta and other starchy foods; one third for fruit and vegetables; 15% for milk and dairy foods; 12% for meat, fish, eggs, beans and other non-dairy sources of protein; and 8% for foods and drinks that are high in fat and/or sugar.






Figure 3 Hospital food needs to be in accordance with the patient’s assessed care planDescriptionThe picture shows a male healthcare assistant offering food to a female patient who is sitting up in bed. The healthcare assistant is lifting the lid off a tray of food and smiling.






Figure 4 The physical environment can cause slips and trips (left); activities at work can cause musculoskeletal disorders (centre); people can experience work-induced stress (right) DescriptionThe picture shows three examples of health and safety issues. The first image shows a man on the floor in pain next to a yellow ‘Caution: wet floor’ sign. The second image shows a lady carrying three large boxes balanced one on top of the other, which reach to above her nose. The final image shows a man in a shirt and tie sitting in front of a computer and looking stressed and tired, holding his head in his hand.






Figure 5 Frequently missed areas of hand washingDescriptionThe diagram shows the palm and back of a person’s hand. Different sections have been colour coded in purple (to demonstrate areas of the hand which are frequently missed during hand washing) and red (to demonstrate those areas which are most frequently missed). Areas frequently missed on the palm side are the tip of the index finger, base of the ring finger and around the base of the thumb into the mid-palm area, and (on the back of the hand) the ring finger, base of the other fingers and across the central section. The most frequently missed on the palm side are the tips and bases of the middle and ring fingers, below the index finger and the most central section, and on the back of the hand the thumb, ring finger and top sections of the other fingers.






Figure 6 Special bins are provided for clinical waste in healthcare settings (left; this one shows the international symbol for biological hazard); sharps boxes are also provided for the safe disposal of sharp instruments (right) DescriptionThe first photo shows a silver pedal bin with a yellow sticker on the front saying ‘Biohazardous/ medical waste’ and bearing the international symbol for biological hazard. The second photo shows a small yellow plastic box for the disposal of sharp objects; a warning at the top of the box says ‘Warning do not fill above the line’, and another notes ‘Danger, destroy by incineration’.






Figure 7 Personal protective equipment will protect you from contamination from blood and other body fluidsDescriptionThe picture displays a female healthcare worker putting something into a yellow clinical waste bin. She is wearing a pink disposal apron and blue disposable gloves.






Figure 8 Putting a casualty into the recovery positionDescriptionThe picture shows a lady lying in the recovery position on the floor, with her eyes shut, and her left arm by her head. A person is holding her forehead and chin to place her into the correct position.






A healthcare assistant who loves her jobTranscriptGail:Ooh I love everything about it ̶ I absolutely adore my job! There’s not a day that I get up that I feel that I don’t want to go to work. Even when I know that it’s going to be a really heavy day, or even if I’ve had a bad day the day before, I just adore my job! I adore caring for patients ̶ I wouldn’t want to do anything else!

Back to Session 1 MediaContent 1





A day in the life of a hospital ward: working with patientsTranscriptAnn:I like looking after the patients that need a lot of help really. You know like as regards hygiene and people that can’t do a lot for themselves. It’s nice to care for them, and know that you’ve got them washed and dressed in the morning after they’ve been laid in their bed all night. You’ve got them up, they smell nice, you’ve combed their hair, you’ve put curlers in, things like that.As a nurse you’re there any time of the day for anything. You’re there to talk to, to cry with, to laugh with. If you can’t look after yourself, you’re there to do things for people, and to look after the medical side I suppose.James:We have a patient on the ward at the moment whose prognosis so to speak isn’t very good. Something happened that upset her on the ward, something to do with another patient.Just feeling able to sit with her and to help her sort of discuss the feelings she was having at that time, so that after half an hour or so she felt more comfortable with what had happened. Jackie:I think, giving good care is listening to what the patient and the family want, first and foremost, because I think that’s something that doesn’t always happen. Keeping the patient and the family well informed is another thing. Making sure that they feel physically, as well as they can do, in terms of being clean and making sure that they’ve been fed and making sure that they…they know their way round and things like that. Treating everybody with respect and with kindness, I think that’s giving good care.






Support with eating and drinkingTranscriptJackieEating and drinking in an institutional environment can be quite traumatic. When somebody has got an impairment such as MS with visual impairment as well, you don’t want to eat, you haven’t got the enthusiasm to eat, you don’t want to enjoy your food. But on top of that you also have these physical difficulties that you have to deal with. It can be that visually you can’t actually see the food on your plate in which case you would need somebody to tell you what the food is, where it is positioned on the plate using perhaps a clock face for that. Using cutlery can be quite difficult also, you need to know where the cutlery is, perhaps somebody needs to put it into your hand. Getting the food from the plate to your mouth is very, very difficult when you haven’t got full control of your hands. I absolutely hated somebody feeding me, I would rather not eat than have somebody feed me, I’d rather not do that and they did leave me for a couple of days really to see how I went. I was just eating finger food but I wouldn’t eat properly because I couldn’t bear for somebody to feed me. Now that's a difficulty somebody would have to have help with, to overcome those things, and that takes a lot of psychological support there. Everybody is different, everybody will deal with that in a different way and it is for each individual nurse to get to know the patient that she’s with.






Health and safety on the wardTranscriptGail:Health and safety is ongoing, daily, all through the day.You have to make sure that you are working in a safe environment for your patients and for the staff that are on with you, so you are always looking, always making yourself aware of what could happen – that’s the key – what could happen. If you see something lying on the floor, a patient could slip on that – you pick it up, you deal with it. If there’s a wire on the floor, they could trip over it. If the patient doesn’t have any footwear on, they could slip. All the day, all the time that you are looking for patients, health and safety is on your mind, you’re looking around at things, you’re making sure that the area is safe for that patient – and for yourself!






The Lodge: public spaceTranscriptThe Lodge is a purpose-built residential and nursing home,

designed for dementia care.

Lorraine Haining, Head of Dementia Services, The LodgeThe main feature really is the shape of the building. It’s been built in a triangular shape so that it offers people the opportunity to walk right through the building. In the centre of our triangle we have a fantastic open plan garden space which is very secure, but it also offers people the opportunity to go out into the garden and use it independently. We have two communities on our ground floor and two communities on our upper floor, and in the centre of that we have a place where everybody comes together, called the Market Square, and that’s really about people joining together to enjoy life and, you know, to occupy themselves.

Wide, well-lit corridors are central to the dementia-friendly design.

We try to use natural light where we can. All round the outside of the building the windows are down to the floor so that, you know, anything that comes through the daylight is the best that we can get it, but the corridors down the middle of the communities don’t have any natural light, but we have them very well lit so that people can see, you know, where they’re going and they can see what’s around them, if you like. The space in the corridors as well, there’s sometimes they’re eight feet wide so it allows people to pass without any interactions. People often have spatial awareness issues that are in our nursing communities so they might not move out of the way when somebody comes, or they might walk into people so, because of the space there, we avoid most of those conflicts. Lucy Ewbank, Care AssistantWhen a resident gets agitated we often take them down the corridors because it’s a quiet place usually, you know just to have a walk down, and they have a sit down where like the birds are, and just sit in a different room. And it’s more quiet, and you can talk to them more easily if you just take them out of the noise and just sit down them somewhere quiet. It’s so much better to just get through to them and calm them down, and then take them back and they’re so much more relaxed. Lorraine Haining, Head of Dementia Services, The LodgeWe’ve tried to go for plain coloured carpets, we’ve not got anything that’s got a pattern on it, and we’ve tried to run that through the building, you know, particularly of 74 27th February 2019




in the communal areas. We have gone for some wooden flooring in the dining area, really for cleanliness reasons, and we’ve tried to minimise the connection between those two. We had silver gripper bars originally separating the two areas. However they were actually, people were finding them quite a hazard really. People were stepping over them, thinking it was a step up, so we actually did a little bit of research and we found that the gold-coloured gripper bars were less reflective, so we’ve actually replaced them, and people are having less problems with that. We very rarely find people trying to step up over it now. Although we have open plan areas each space is very distinct so you still know it’s a dining room, you still know it’s a lounge, you still know it’s an activity area. There are open plan book spaces between each area to make it distinct, but that then offers cues to people who are maybe sitting in the lounge, they see something happening in the activity area, and then they can actually, that draws them into the activities. So people actually can see all around them what’s happening. Lucy Ewbank, Care AssistantIt’s brilliant to see what’s going on around you, and to make sure that, you know, the residents are safe. We can look after one resident but while we’re looking after one we can keep an eye on the rest of them, so that’s brilliant. Lorraine Haining, Head of Dementia Services, The LodgeThere is some evidence to show that people with dementia don’t do well in an enclosed space with closed doors ‘cos they don’t always get up and look out, whereas if you actually have an open plan space people will actually get up and move into areas. It’s like visual cues so that they actually engage and interact with what’s happening in the environment.

Good design is not only about continuity, it’s also about contrast.

Lorraine Haining, Head of Dementia Services, The LodgeAny toilet area in the whole of The Lodge has a bright yellow door. It’s just a colour cue that we find actually helps quite a lot of people with dementia. It doesn’t work for everybody but it does work for quite a few people, and we find it maintains independence and it also preserves dignity 'cos people can then find a toilet quite easy. In relation to doors that we don’t want people to use, like the sluice, we colour them the same as the natural walls that so it doesn’t draw people towards that. Everybody has their own front door, just like in an apartment block really. What we’ve done is we’ve sourced a different colour for every single apartment door in the building, and that was no mean feat. They also have a number plate on it that’s easy to see, it stands out, and some people have also, they’ve got little way-finders so they have little pots or things outside their front door, like you would have at home. When they see the little pot or the umbrella stand they remember that that’s where they live. Lucy Ewbank, Care Assistant





For the residents to find their own way to their apartment is really good because their independence is boosted again, you know. They found their own room with their own furniture, with their own toiletries and stuff, their own clothes.





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