Person-centred care
Care home residents and health professionals (for care under the NHS) have rights and responsibilities as set out in the NHS Constitution for England, and NICE guidelines are written to reflect these. Treatment and care should take into account individual needs and preferences. Care home residents should have the opportunity to make informed decisions about their care and treatment, in partnership with their health professionals and social care practitioners.
If the resident is under 16, their family or carers should also be given information and support to help the child or young person to make decisions about their treatment. Health professionals should follow the Department of Health's advice on consent.
If someone does not have capacity to make decisions, health professionals should follow the code of practice that accompanies the Mental Capacity Act and the supplementary code of practice on deprivation of liberty safeguards.
All health professionals should follow the recommendations in the NICE guideline on patient experience in adult NHS services and where appropriate the NICE guideline on service user experience in adult mental health, although many of the principles in that guideline apply equally to social care staff.
If the resident agrees, families and carers should have the opportunity to be involved in decisions about treatment and care. Families and carers should also be given the information and support they need.
The person-centred care approach is not new across sectors and resources such as Think Local, Act Personal, help to support this working.
Involving others
The views of residents in care homes about who should and should not be involved in their care are important and should be respected. If the resident lacks the capacity to decide who should and should not be involved, health and social care practitioners must act in the resident's best interests, taking account of the provisions in the Mental Capacity Act 2005.
Health and social care practitioners should also consider accounts from family members or carers of the resident's usual behaviour. This information, when used with an assessment of the resident concerned, will help with specific decisions about their care. It will also help to estimate the person's capacity to make a specific decision. Residents with reduced mental capacity should continue to have the opportunity to make informed decisions about those aspects of their care and personal lives for which they retain capacity.
Good communication between health and social care practitioners and residents, their family members or carers (as appropriate) is essential for residents to receive the information and support they need. Evidence-based information should be offered in a form that is tailored to the needs of the individual resident. The treatment, care and information provided should be culturally appropriate and in a form that is accessible to residents who have additional needs, such as physical, cognitive or sensory disabilities, or who do not speak or read English.
If the resident agrees, families and carers should have the opportunity to be involved in decisions about treatment and care. Families and carers should also be given the information and support they need, and carers should be offered an assessment of their own needs.
Keeping residents safe (safeguarding)
Similar definitions exist for safeguarding of adults and children from the regulators of adult and children's services.
The Care Quality Commission's Essential standards of quality and safety (2010) define safeguarding adults as: 'Ensuring that people live free from harm, abuse and neglect and, in doing so, protecting their health, wellbeing and human rights'.
The Department for Education's Working together to safeguard children (2013) defines safeguarding children as: 'protecting children from maltreatment; preventing impairment of children's health or development, ensuring children are growing up in circumstances consistent with the provision of safe and effective care and taking action to enable all children to have the best outcomes.'
A safeguarding issue in relation to managing medicines could include the deliberate withholding of a medicine(s) without a valid reason, the incorrect use of a medicine(s) for reasons other than the benefit of a resident, deliberate attempt to harm through use of a medicine(s), or accidental harm caused by incorrect administration or a medication error.