PPT 3 - Different Acts for Health, Social Care and Children’s Provision

1. PPT 3 - Different Acts for Health, Social Care and Children’s Provision Lesson objective – to learn why legislation is put in place and what Acts protect different client groups. PPT 3 -

2. Updates to recent legislation in Health and Social Care services • Many changes in legislation in health and social care relate to vulnerable groups in society such as children and those with mental health problems.

3. Disability and the Equality Act 2010 • The Equality Act 2010 aims to protect disabled people and prevent disability discrimination. It provides legal rights for disabled people in the areas of: • employment • education • access to goods, services and facilities including larger private clubs and land based transport services • buying and renting land or property • Functions of public bodies, for example the issuing of licences • The Equality Act also provides rights for people not to be directly discriminated against or harassed because they have an association with a disabled person. This can apply to a carer or parent of a disabled person. • In addition, people must not be directly discriminated against or harassed because they are wrongly perceived to be disabled.

4. The definition of ‘disability’ under the Equality Act 2010 In the Act, a person has a disability if: • they have a physical or mental impairment • the impairment has a substantial and long-term adverse effect on their ability to perform normal day-to-day activities • For the purposes of the Act, these words have the following meanings: • 'substantial' means more than minor or trivial • 'long-term' means that the effect of the impairment has lasted or is likely to last for at least twelve months (there are special rules covering recurring or fluctuating conditions) • 'normal day-to-day activities' include everyday things like eating, washing, walking and going shopping • People who have had a disability in the past that meets this definition are also protected by the Act.

5. Disability Discrimination Act 1995 • Discrimination is classed as barriers towards: • access to goods, services, facilities and premises • The Equality Act also of 2010 provides important rights not to be discriminated against or harassed: • in accessing everyday goods and services like shops, cafes, banks, cinemas and places of worship • in buying or renting land or property • in accessing or becoming a member of a larger private club (25 or more members) • in accessing the functions of public bodies • Grab rails in toilets • Ground floor rooms for clients using the services (e.g. in a solicitor’s office)

6. Children Act 2004 • In September 2003, the Government published the Every Child Matters Green Paper alongside its formal response to the Victoria Climbié Inquiry Report. • The Green Paper proposed changes in policy and legislation in England to maximise opportunities and minimise risks for all children and young people, focusing services more effectively around the needs of children, young people and families. • The consultation on the Green Paper showed broad support for the proposals, in particular the intention to concentrate on outcomes that children and young people themselves have said are important, rather than prescribing organisational change. • The Act has been produced in the light of this consultation and gives effect to the legislative proposals set out in the Green Paper to create clear accountability for children’s services, to enable better joint working and to secure a better focus • Part 1 of the Act provides for the establishment of a Children’s Commissioner (in these notes referred to as ‘the Commissioner’). • Under section 2, the Commissioner’s role will be to promote awareness of the views and interests of children (and certain groups of vulnerable young adults) in England on safeguarding children.

9. Bringing you up to date with the ‘Every Child Matters’ agenda - Green Paper 2003. The Department for Education (DfE) has moved to allay fears that a ban on the use of the phrase Every Child Matters in the new government signals a shift in policy for children and young people. Details of the changes in terminology are revealed in an internal DfE memo, split into two columns for words used before 11 May (when the coalition took office) and those with which they should be replaced. Key changes to phrases in the children's sector include the replacement of safeguarding with child protection, children's trusts with "local areas, better, fairer, services'" and using the term "help children achieve more" in place of Every Child Matters or the five outcomes. John Chowcat, general secretary of children's services union Aspect, said he fears the change in language represents a gradual move away from the Every Child Matters agenda by the government. "I could not imagine this government making a bold announcement to the effect that Every Child Matters has gone or anything like that," he said. Organisation that have voiced concerns over the wording of this agenda see this process as a demoralisation process towards child agencies. NSPCC and 4Children chief executive have spoken up the reply is as follows: "The principles of Every Child Matters are observed in the field and people will continue to use those approaches even if they might not refer to it in the same way."

10. Task 1 – Standard 4 of the National Services Framework for children, Young People and Maternity Services, ‘Growing up into adulthood’ Standard 4 : All young people have access to age-appropriate services which are responsive to their specific needs as they grow into adulthood. Young people supported to make the transition to adulthood and to achieve their maximum potential in terms of education, health, development and well-being. Young people taking responsibility for their own health and making informed choices and decisions regarding their emotional and social development, and health and well-being both now and in the future. Services and staff who are able to respond in a sensitive way which encourages engagement and provides high-quality support for young people. Questions: What factors may affect a young person’s transition into adulthood? (Thinking back to Unit 1 will help you answer this.) What organisations and professionals may be able to help the young person? How might the family offer support and who could support the family? AfL – through discussion and self assessment Markers of good practice 1. All services working with young people have policies and procedures which ensure that their confidentiality and rights are respected. 2. Young people are consulted in the planning and development of local services. 3. Services address targets for the reduction of teenage pregnancy, smoking, substance misuse, sexually transmitted infections and suicide through the provision of targeted and/or specialist services which are sensitive to young peoples' needs. 4. Young people in special circumstances receive targeted and/or specialist services to meet their needs which are easily accessible and of the same standard in all settings. 5. All transition processes are planned in partnership and focused around the preparation of the young person. 6. Young people up to eighteen years of age with mental health problems have access to age-appropriate services. 7. All services for young people contribute towards assisting young people to take on increasing responsibility for their own lives. 8. Services seek to support parents, in particular providing information and advice on how they can appropriately support their child's transition to adulthood. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/Browsable/DH_4094329

11. AfL http://www.youngminds.org.uk/parents/transitions-guide/4.-how-does-an-assessment-work

12. AfL

13. AfL The social support and physical health are two very important factors help the overall well-being of the individual/young person into adulthood. First, professionals would look at the amount of attachment provided from a lover or spouse. Second, measuring the level of social integration that the individuals involved with, it usually comes from a group of people or friends. Third, the assurance of worth from others such as positive reinforcement that could inspires and boosts the self-esteem. The fourth criterion is the reliable alliance support that provided from others, which means that the individual knows they can depend on receiving support from family members whenever it was needed. Fifth, the guidance of assurances of support given to the individual from a higher figure of person such as a teacher or parent. The last criterion is the opportunity for nurturance. It means the person would get some social enhancement by having children of their own and providing a nurturing experience. For adolescents, family support is the most important element in their lives. As part of their growth experience, adolescents usually expect a lot of things from their parents. Inadequate support from the parents will likely increase the chance of getting depression among adolescents who get into unfortunate situation with their parents. This occurs because adolescent usually become confused when they expect to get plenty of help and positive reinforcement from their parents, but it does not happen. Beside family support, peer support also is very important factor for adolescents. Children can expect a lot from their friends. Peer support can be considered as an alternate method of getting social support if the adolescents receive inadequate attention from their parents. This social support method is not as reliable as family support because young children could easily withdraw from their own friends if they become depressed. Another problem arises in this area, when the depressed students isolate themselves from public gatherings. This would prevent those suffering adolescents from getting any social support at all (Stice et al., 2004). Receiving social support is very essential for adolescents to become successful with themselves and achieve a satisfactory level at school. Triple P (positive Parenting Program) Pastoral Team in Schools Community Social Care Careers Preparation Voluntary Sector / many organisations that promote support network for parents and adolescents.

14. The Health Act 1999 • This Act reformed primary care, allowing the creation of Primary Care Trusts, and requiring all hospitals trusts to improve their services. The Act also allowed the introduction of: • Walk-in high street health centres • Increased use of day surgery in health centres • Health checks and advice sessions in new clinics • One-stop shops-varied health care services at one site • Wider partnerships, encouraging GPs to team up with pharmacists, counsellors and dentists to provide a range of services from one site.

15. The Mental Health Act (1983) • The mental Health Act (1983) lays down the rules for compulsory admission to hospital if a person with mental illness poses a risk to the health and safety of themselves or others. The hospital is expected to follow the mental health code of practice. Members of the Mental Health Commission regularly visit the hospital where patients are detained (including voluntary patients) a chance to meet with them and discuss their care. The Draft Mental Health Bill (2002 and 2004) • A draft Mental Health Bill was introduced in 2002, as it was felt that certain patients with a mental illness were still in the community, where they could cause harm either to themselves or to others. This Bill re-examined the process by which patients are detained in hospital. There has been a great deal of discussion over the contents of the Draft Bill. There were two areas of concern: • Mental illness was defined as a disability or disorder of the mind. Carers and critics were concerned that this board definition would mean the people would be detained against their will. • That people with mental problems in the community would be subject to ‘community order’ and expected to take their medication. This was seen as unworkable to supervise people taking medication and would place another burden on carers.

16. The Draft Mental Health Bill (2002 and 2004) • Because of these problems a new bill was implemented in Spetember 2004. Changes included: • A definition of mental disorder to stress that the effect of the disorder (e.g. violent behaviour) rather than the diagnosis is important. • The Health Care Commission will have a role in monitoring metnalhelath services • A period of hospital assessment will be required before treatment in the community • Patients can refuse ECT (electro-convulsive therapy) if they retain the mental capacity to make an informed decision. However, the delay of the implementation are that: Psychiatrists last night condemned the government's latest attempt to reform mental health law in England and Wales as "objectionable, unworkable and likely to bring NHS services to their knees". Ms Winterton said 130 extra psychiatrists and about 900 other staff would be needed to implement the bill, mostly because of the new safeguards. Many of the new proposals are relating to the Human rights Act.

17. The Draft Mental Health Bill (2002 and 2004) Range of new powers The draft bill would: · Allow non-offending psychopaths to be detained indefinitely "if clinically appropriate" · Introduce compulsory treatment in the community to protect patients in danger of relapse · Allow people to refuse electroconvulsive therapy if they retain mental capacity · Increase maximum sentences for those convicted of ill-treating patients · Establish a new independent tribunal to review every detention lasting longer than 28 days · Provide an independent advocacy service to help patients assert their rights

18. The Human Rights Act 1998 • The Human Rights Act is possibly the most important piece of legislation in the UK regarding human rights. It came into effect in 2000 and is concerned with enforcing the terms of European Convention on Human Rights in UK Law. In this section you will find advice and information on several aspects of the Act, including: • how the Act works • taking a case to the European Court of Human Rights • rights under the Convention. Article 2: everyone’s right to life shall be protected by law. Article 3: no one should be subjected to inhuman or degrading treatment or punishment. Article 5: everyone has the right to liberty and security of person. Article 6: everyone is entitled to a fair and public hearing in the determination of a person’s civil rights and obligation or of any criminal charge brought against them. Everyone is entitled to a fair public hearing within a reasonable time by an independent and impartial tribunal established by law. Article 8: everyone has a right to respect for their private and family life, their home and their correspondence. Article 10: everyone has the right t freedom of thought, conscience and religion. Article 11: everyone has the right to freedom of peaceful assembly and to a freedom of association with others, including the right to form and join trade unions for the protection of their interests. Article 12: men and women of marriageable age have the right to marry and found a family according to the national laws governing the exercise of the right. Article 14: the enjoyment of the rights and freedoms set forth in this convention shall be secured within discrimination on any grounds such as sex, race, colour, language. The aim of the Act is to achieve a fair balance between the public interest and the individual's rights. The Human rights Act overlaps other legislation as the Race Relation Act (1995) and the Disability Discrimination Act (1995). Finally, the Human rights Act does not allow people to bring a case against an organisation that is not a public authority. The Act has changed how courts interpret and develop the existing Law; Human rights Act has also had an impact on informed consent issues.

19. Human rights stopping blanket use of Do Not Resuscitate Orders Task 1 Keeping elderly couples together An older man with dementia was admitted to hospital. He was placed on a ward in which every patient had a ‘do not resuscitate’ order placed on their file. His advocate came to visit him and noticed the DNR, which wasn’t signed by a doctor. She queried it and was told that everyone on the ward had a DNR automatically. The client was not aware of the DNR and his advocate believed him to have some level of capacity to take the information on board. In addition he had two estranged daughters who had visited but were not consulted or informed. She challenged this using the right to life and the right not to be discriminated against. The DNR was withdrawn. Mr V contacted Counsel and Care when social services threatened to move his wife into a care home which was some distance from the family. Mrs V has Alzheimer’s and is blind. Mrs V had temporarily moved into a local nursing home after being hurt in a fall. Mr V was also injured in the fall, and unable to care for his wife at home. Social services decided Mrs V should be moved to a permanent care home but Mr V disagreed with the home social services chose, because it was too far for him and other family members to travel to see Mrs V. Counsel and Care helped Mr V to challenge this decision, by providing information on community care laws, and combining this with the argument that social services needed to consider Mr V's right to private and family life under the HRA (Article 8). This helped Mr V persuade social services to allow Mrs V to remain in the nursing home close to her family. Read these case studies and decide which Human Rights Articles are being infringed.

20. Summary of Section Health Statutory services Independent sector Private sector Social care Structure and provision of service Voluntary sector Range of client groups Informal care Children Adults Older people Legislation