Answers To Questions In S NVQ Level 2 Health Social Care Easy Steps Unit 21 Communicate With And Complete Records For Individuals

Answers to questions in S/NVQ Level 2 Health & Social Care Easy Steps
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Unit 21 Communicate with and complete records for individuals
In the workplace: Jake likes to joke (page 7)
1 No, there will be many occasions when an individual does not want to laugh and joke,
especially if they feel sad or angry. Jake should respond in a way that recognises the way they
are feeling at that time.
2 Jake might have to be more serious in formal meetings or when talking to individuals about
serious matters.
3 Jake should be polite and professional when speaking to his manager.
In the workplace: Facial expression (page 8)
1 ‘Yes’– nodding head;‘No’– shaking head;‘I don’t know’– shoulders up, raised eye brows;‘I’m
happy’– smiling;‘I’m sad’– corners of mouth down;‘I’m confused’– wrinkled forehead and
nose;‘I’m angry’– gritted teeth, squinted eyes.
2 Students’own answers.
In the workplace: Is she just shy? (page 11)
Asia is communicating that she is not happy to be examined by the male doctor. Asia may not want
to be examined by him because it may be against her culture and beliefs to be touched by a man
who is not her husband.
In the workplace: Stephanie’s new job (page 13)
1 Stephanie can ind out how service users communicate by reading their care plans, talking
to colleagues, observing the individuals, and by talking to them, or their family and friends.
In the workplace: Sharing information (page 19)
1 The service users would have to repeat themselves again to another member of staf to give
them the information they need. In the meantime the staf would ind it diicult to meet the
needs of the service users.
Have a go: Positioning yourself correctly (page 22)
The care worker is at the same level as the service user, and he is making eye contact. He is in the
correct position for communication. Watch out for where you position yourself though. On a sunny
day, this service user would have trouble seeing the care worker because of the strong light coming
through the window behind him.
Have a go: Questions and concerns (page 28)
Questions should only be answered by the people who have the proper qualiications or job role to
give the answer. The answers given in the table are:
inappropriate; appropriate; inappropriate; inappropriate; inappropriate; appropriate; inappropriate;
inappropriate; inappropriate.

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In the workplace: Christy’s classes (page 31)
Christy should ask the manager irst, as managers have overall responsibility for what goes on in
the home. She should then speak to the doctor to make sure that the residents are well enough to
exercise. Christy should also ask the physiotherapist to identify the types of exercises and activities
the residents could do.
In the workplace: Wilf’s hearing aid (page 39)
Firstly, Amal should check Wilf’s hearing aid is working correctly. The meeting should be in a quiet
room where there will be no distractions. Wilf and the social worker should sit opposite each other.
The lighting should be good, but not too glaring. Encourage Wilf to ask the social worker to repeat
anything he does not hear or understand. Encourage the social worker to speak slowly and clearly.
During the meeting, Amal should observe Wilf’s body language to check his understanding, and she
should give him reassurance where necessary.
In the workplace: Shirley’s speech has changed (page 42)
1 Paul should report this to his manager or supervisor immediately, as this could be an indicator
that Shirley has a serious health problem.
2 Shirley’s speech may have become slurred due to a stroke, brain tumour, brain haemorrhage
or a head injury.
In the workplace: George is in a hurry (page 46)
1 The iling cabinet was not locked when George accessed it. Anyone could have removed the
iles and read them, which would break conidentiality. When George left the ile on the desk,
an unauthorised person could have read the ile.
Think about it (page 47)
The individual’s home could be broken into, as people would know the home owner is in
hospital or a care home.
Have a go: Fact or opinion? (page 51)
You must write what you can actually see or hear, and not write notes based on what you think or
feel is the case.
1 Factual, based on what the service user said. There is no visible evidence that Mrs T has a
headache, so it is important that the statement says‘Mrs T said she had a headache.’rather
than‘Mrs T had a headache.’
2 Factual, if you have seen evidence of a stomach upset (i.e. Mrs B has been sick or has
diarrhoea). Opinion, if this is just what Mrs B tells you.
3 Factual, if you know that Mrs L has had a bath.
4 Opinion, it is just your impression that Mrs H looks a bit down this morning.
5 Opinion, you cannot see or hear constipation. If you know that someone has not opened their
bowels for two days then you should write that.

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What have I learned? (page 52)
1 Factors that can afect communication include: learning disability; physical disability; mental
health issues; personality; culture; personal beliefs; environment.
2 To ind out how an individual communicates you can observe the individual or ask them
questions; speak to colleagues or other professionals; look through case notes or speak to the
individual’s family or friends.
3 Skills needed to communicate well include: observation skills; listening; patience; a good
memory; understanding; being responsive; being non-discriminatory.
4 A barrier is something that gets in the way or prevents an action. Barriers to communication
could include large tables, desks, lack of privacy, noise, or even a person’s mood.
5 To show you are listening use appropriate body language, such as sitting forward and nodding
your head. You can also use appropriate sounds, and occasionally repeat the last few words of
a sentence.
6 Ways of communicating include: speaking; shouting; singing; whispering, touch; sign
language; Makaton; facial expressions; body language.
7 Conidentiality means keeping private information secret.
8 You can keep information safe by telling only those who have a right to know, keeping records
in a locked cabinet and using passwords for information kept on a computer.
9 The Data Protection Act is a law that tells you how you should treat conidential information
about individuals.
10 When writing records you should write clearly, accurately, precisely and completely.
Case study (page 53)
Miriam
1 To ind out the diferent ways that Miriam communicates, observe her and talk to her. Speak to
Miriam’s family and the unit manager, Julian. Read Miriam’s case notes.
2 To get permission to see Miriam’s records, you could speak to Julian, the unit manager, and tell
him why you need access.
3 It could be breaching conidentiality if the records contained information which you did not
have a right to see.
4 Read Miriam’s notes where no one can look over your shoulder. Lock them in the cabinet after
you have inished reading her notes.
5 When communicating with Miriam, you could kneel down, so that your eyes are at the
same level. Give Miriam time to respond to questions. Listen to her carefully and respond
appropriately with sounds, repeating what she has said. Nod and smile where appropriate. Ask
her to repeat something if you have not understood.
6 Record this new information in Miriam’s notes so that there is a permanent record, and
everyone else can read it. Inform the staf at handover so that they are also aware of the new
information on how Miriam communicates.
7 You should complete records accurately, legibly and completely so that people can read what
is written without having to guess and possibly make mistakes. It is also a legal requirement
that records are accurate, legible and complete and it is your responsibility as a care worker.

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Unit 22 Support the health and safety of yourself and
individuals
In the workplace: Bridie’s poor sight (page 58)
1 Hazards may include: furniture; falling down the stairs; cat; mice; cat vomit; mixing human and
cat food; out-of-date food in the fridge.
2 The risks are:
• Bridie may bump into furniture, and hurt herself.
• She could fall down the stairs, especially if there is clutter on them that she cannot see.
• She could trip over the cat.
• The cat leaves unhygienic remains of mice and vomit, which could attract lies. If the lies
then land on food Bridie eats, she could become very ill.
• The cat could have worms or leas if not looked after properly. If Bridie scratches the bites,
they could become infected.
• Bridie could mistake the cat’s food for her own. Eating cat food could make Bridie ill.
• Food in the cupboards and freezer may be out of date because she cannot see the dates to
rotate the items, and use the oldest foods irst.
• Food that is out of date could make Bridie very unwell.
3 The care worker should report these problems to the manager, and could make the following
suggestions:
• The care worker could ask Bridie if there is any furniture that she would be happy to sell or
give away. If not, suggest that Bridie may like you to move some items into a room that is not
used. Encourage Bridie to decide where items should go, and with her permission rearrange
the furniture to make the area less cluttered.
• A stair lift would make it safer to get up and down stairs. If she slept downstairs, and if
there’s a downstairs toilet, Bridie could avoid using the stairs.
• The care worker could help make sure that the cat has regular lea and worm treatments, as
well as check-ups by the vet.
• The care worker could store the cat’s food in a separate cupboard from Bridie’s food and
make sure Bridie knew which was which. Large-print labels on food tins would enable Bridie to
see what they contain.
• If Bridie had support with cleaning, the cleaner could ensure any mess was cleaned up.
• The care worker could rotate the food so that the oldest is used irst. Using coloured
highlighters and large print would help Bridie to tell which foods to use irst. The care worker
could check the fridge on each visit to make sure that there is no out-of-date food. The freezer
and store cupboard could be checked regularly also.
In the workplace: The Briars (page 59)
1 Hazards include: hot surfaces, such as the oven or cooker; hot water; sharp objects, such as
scissors and knives; substances, such as cleaning luids and glue.
2 The service users may have an accident. For example, they could cut or burn themselves
(accidentally or deliberately).
3 Keep a look out for things that might harm service users. Keep sharp knives and dangerous

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substances locked away; make sure they are only used under supervision.
Have a go: How to deal with the hazards in the p 57 spidergram (page 60)
• Wet slippery loors: put out hazard warning signs; tell residents that the loor is wet; clear up
spillages quickly and correctly.
• Sharp objects lying around: put sharp objects e,g. scissors and knives away. Dispose of
broken glass properly.
• Working alone: let others, for example, your supervisor, know where you are. Carry a mobile
phone and make sure that you have enough credit to make calls. If going to areas where there
is a weak or no signal, let someone know where you are going and the time you expect to
return. Let them know you have returned safely. Carry a personal alarm and know how to use
it. Check batteries regularly.
• Trailing wires: tidy away trailing wires to avoid trips and falls.
• Faulty equipment: make sure that all equipment is checked regularly and don’t use items
that are not working properly. Remove the faulty item and report it.
• Poor security: make sure that all windows and doors are secured properly, and that there
are proper window locks. Check the identity of visitors. Close curtains and blinds at night so
people cannot look in.
• Don’t tell others when a house will be empty, for example when you or a service user is
going on holiday. Use timers so that lights come on when someone is away so that it looks like
the person is still there. Ask a neighbour to park their car in the drive, pick up any mail that is
sticking out of the letterbox and to keep an eye on the house.
In the workplace: Stuart – a desperate situation (page 61)
1 Risks to the workers and service users include violence and physical harm; possibility of needle
stick injury; cross infection from blood and body luids e.g. hepatitis and HIV.
2 To reduce these risks, the care workers could make sure that the medical team or drugs
advisory experts help manage Stuart’s drug dependence. Staf should have training
sessions about handling aggression, for example they should not raise their voices or have a
threatening tone. They should use good communication skills to encourage Stuart to sit down,
and listen to what he has to say. They should follow their workplace policy. Staf must be
aware of their own safety, make sure that they are positioned near to the door, have support
from other care workers and that others know what is happening.
3 The care workers could ask for advice from drugs advisor experts for more help with ways of
communicating with Stuart and understanding his behaviour. Stuart’s family may be able to
give advice about how he responds to some situations and what helps.
Have a go: Health and Safety records (page 62)
Answers will depend on each learner’s own workplace, but could include: visitor’s signing-in book;
risk assessment forms; incident reporting forms; COSHH forms; equipment-checking forms.

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In the workplace: Safety first (page 62)
1 Records Sharon should complete include: risk assessments; cutlery and equipment checks;
records of incidents and accidents. She may also need to record where service users are at
diferent times.
2 These records help to keep service users, care workers and property safe, and reduce the risk
of incidents occurring. Recording incidents can help to show the likelihood of some types
of incidents, so that safety measures can be put in place. For example, if there were several
incidents at a time when the care workers are very busy, then more staf might be brought
in at that time. Or there may be changes made to shift patterns to make sure there were
suicient care workers at high-risk times.
In the workplace: Checking equipment (page 63)
1 Molly signs to record that the equipment has been checked. Then other people will not
assume the equipment has been checked when it hasn’t.
2 If she inds some equipment is not working properly, Molly should label the piece of
equipment to say that it is faulty, remove it and report it so that it can be repaired. If agreed
with her manager, she should replace it if possible, or arrange for this to be done.
In the workplace: A near miss (page 66)
1 The surgeon did not continue because Martyn had not given consent.
2 Report of Injury, Disease and Dangerous Occurrence form (RIDDOR) should be completed.
3 Always follow procedures properly, step by step. Don’t become distracted when doing things.
Filling in a RIDDOR incident reporting form as a near miss will highlight the problem, and can
help to prevent the same thing happening again.
4 The information on RIDDOR forms is conidential, only the people involved and the managers
should have access to the information. The Health and Safety Executive will be informed.
Never talk about things outside work.
In the workplace: Shauna’s slip up (page 70)
1 Shauna put the soiled nightdress in the white bag and her gloves in the waste paper bin.
2 Shauna put the people who work in the laundry at risk of contamination from handling soiled
linen. Because the gloves were in the wrong bin, they could have been wrongly disposed
of, e.g. put into landill instead of incineration. The workplace could incur a ine for wrong
disposal of waste and putting people at risk.
3 The soiled sheets and nightdress should have been put in a red bag (with a liner). The gloves
should have been put in a yellow bag.
In the workplace: Emile smokes (page 77)
1 Emile is at risk of getting smoking-related infections and diseases, e.g. more coughs and colds,
heart and lung diseases, and cancer.
2 Smoking is afecting Emile’s health, as he has a cough most of the time. He may be of work
more often because of colds and chest complaints, which may cause staing problems. Emile’s

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clothes and breath will smell of smoke, which is unpleasant for the staf and pupils he works
with.
3 The head teacher has asked the children not to smoke, so the parents are concerned that
Emile is not providing a good role model for the children, who look up to him. Some parents
might think that Emile is smoking around their children and bringing on their asthma attacks
(which may not be correct). They may feel he passes on colds and chest infections to their
children, too.
In the workplace: Mary has the flu (page 79)
1 No, Mary should have waited until she was better.
2 It could take Mary longer to get over‘lu, because she may not get the rest and the care that
she needs.
3 People in hospital are usually ill already, and their immune system may not be working well.
Catching‘lu could make them extremely ill, and could even be life threatening.
In the workplace: A broken window (page 81)
1 The immediate danger is that the intruder gets in and harms the service users and property.
2 Maria should inform the police and her supervisor.
3 She should also ill in an incident form.
In the workplace: Unwelcome visitors (page 82)
1 Service users are at risk because their personal details, such as their address, and how to get
into their house will be known by someone who might cause them harm. The service users are
at risk because they are vulnerable and may not be able to protect themselves.
2 The service users could be burgled and attacked or injured. They could be afected
emotionally if they know someone has this information, and become very scared, lose
conidence and not sleep very well.
3 This could have been avoided if Emlyn had not written down personal information about the
service users in a way that made them easy to identify. Emlyn should have taken the work bag
out of the car and kept it with him. If bags or items need to be left in the car, make sure that
they are out of sight by putting them in the boot. The data should be password-protected.
In the workplace: Is Henry smoking? (page 85)
1 Care workers may smell smoke, or see cigarettes, matches and ash in Henry’s room.
2 Smoking could cause a ire, which puts Henry and everyone else in the building at risk.
3 A risk assessment must be completed. Records of events need to be documented in Henry’s
care notes. The care home manager needs to make sure that Henry is aware of the smoking
rules and must explain the ire risks to him. The manager should double check that there are
suicient smoke detectors, and that they work, changing the batteries regularly. The local
ire service can be asked to visit and give any additional advice. Care workers should support
Henry to access any smoking areas that have been provided. It may be necessary for care staf
to look after Henry’s cigarettes and lighter.

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In the workplace: Mrs Farr’s table (page 87)
1 Amy had to ill in an accident report form because all incidents must be reported under
RIDDOR. This may help to prevent another similar incident happening.
2 To help ill in the form properly, Amy could refer to‘Ten top tips for illing in forms well’, also on
page 87.
1 Students’own answer, but may include hazards such as hot surfaces, trailing wires, chemicals,
e.g. cleaning solutions, heavy storage items and aggressive service users.
2 Risks you may ind in your workplace could include:
• slips, trips and falls due to wet loors, unsteady or confused service users
• attack and injury due to working alone, for example domiciliary workers or workers caring
for confused or aggressive service users
• poisoning, for example if cleaning solutions are not locked away a service user might drink
them
• service user not receiving the right treatment. For example medication and treatment
procedures not properly followed
• food poisoning if food is not stored or prepared properly
• burns when working with hot items, for example cookers and hot water
• harm to care worker’s own health, e.g. being exposed to substances such as sterilizing
solutions and x-rays
• electrocution due to faulty electrical equipments
• risk of burglary and intruders.
3 A risk assessment looks at the likelihood that somebody will be harmed by a hazard. A risk
assessment form is a report that shows the harm that might happen and suggests safe ways of
working to reduce the risk.
4 Records relating to health and safety could include: visitors’signing-in book, risk assessment
forms, incident reporting forms, COSHH forms, equipment checking forms.
Your own workplace may have additional forms relating to health and safety.
5 Regulations under the Health and Safety at Work Act include: Manual Handling Regulations
1992; Control of Substances Hazardous to Health (COSHH) 2002; Reporting of Diseases and
Dangerous Occurrences Regulations (RIDDOR) 1995; First Aid Regulations 1981; Management
of Health and Safety at Work Regulations 1999.
6 Your responsibilities under Health and Safety Law include:
• to take care of yourself and others. To cooperate with your employer
• not to interfere or misuse any health and safety equipment
• to report dangerous situations to your manager.
7 Your employer’s responsibilities include:
• to ensure there is a health and safety policy and that the workplace is kept in good
condition
• to make sure equipment is safe and that no one is put at risk
• to provide health and safety training
• to provide Personal Protective Equipment (PPE) free of charge.

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8 You can help control the spread of infection by wearing PPE protective clothing. You should
also wash and dry your hands thoroughly:
• before starting and inishing work
• after using the toilet or blowing your nose
• before and after eating, and before handling food
• before and after touching someone, especially if you might come into contact with any
bodily luids or infection
• after handling any waste or soiled linen.
Always dispose of all waste properly.
9 The correct procedure for disposing of waste is as follows:
• clinical waste, e.g. dressings and used pads – yellow bags
• soiled linen – red bags
• domestic waste – clear or black bags
• sharps – rigid, yellow sharps containers.
10 For a high standard of health and hygiene you should eat sensibly, and get enough rest and
exercise. Don’t smoke, drink excessively or take drugs. Keep yourself very clean and wear
a clean uniform every day. Keep your hair clean neat and tidy and tie long hair back. Keep
jewellery to a minimum. Keep your teeth clean. Look after your feet. Keep your hands and nails
clean.
11 You can protect service users from intruders by following work place procedures. Check
visitors’right to entry, and ask for ID. Use key pads, swipe cards. Make sure the building is
secure, e.g. windows and doors are closed.
12 In the event of a ire, you should raise the alarm. Evacuate the service users, following your
organisation’s procedure, to the assembly point. Do not delay in calling the ire brigade,
even if you feel that you have put out the ire because it is possible that it will start up again.
Depending on your work place policy, and the type of ire, you might have been trained to use
a ire extinguisher, or a ire blanket for small kitchen ires. Remember, if any ire extinguishers
have been used they need to be replaced.
13 You can support others in an emergency by staying calm and calling for help. Comfort people
who are involved, including bystanders. Help the experts when they arrive, and listen to other
people’s feelings after the event.
Case studies (page 91)
Going swimming
1 Tom should include the children’s key workers, the manager, health and safety team (if there is
one), parents/guardians, and the staf at the leisure centre. Also any other care worker who will
be going, and the minibus driver.
2 Risks may include: challenging behaviour; physical harm to the other young people, the
public, and damage to property and equipment; drowning.
Risks on the way there could include road accidents, or accidents when the children get
out of the minibus; possible medical emergencies, such as an asthma attack.
These risks could be reduced by carrying out a risk assessment and being aware of each of
the boy’s abilities and‘trigger factors’, which could lead to challenging behaviour. Make sure

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there are enough care workers to properly supervise the boys. Make sure care workers can
swim. Conirm with the leisure centre that there are suicient life jackets/buoyancy aids and
life guards available. Make sure that care workers are trained in irst aid, and that any necessary
medication that might be needed is taken, for example asthma inhalers. Seat belts must be
worn. Other staf, in addition to the driver, must travel in the minibus with the boys, to ensure
that the driver is not disturbed while driving.
3 Records to be completed include consent forms, risk assessment forms and minibus request
forms. Also activity or outing request forms may have to be completed, including details of
who is going, and where (plus dates, time, method of transport) and why they are going. When
the outing has been approved, a conirmation of this will be given. A record of emergency
contact details, and sometimes doctor’s details, should be completed.
4 This will be diferent in each setting but it should always include a risk assessment and consent
form, and emergency contact details.
Staying at home
1 The risks to Valda are that she may fall and hurt herself if she tries to get out of bed or her chair
to get something. She could fall over clutter and furniture. Care workers may hurt their back
or neck by twisting and turning when working in a small restricted area. They could also injure
themselves if they need to move furniture or belongings to make more room.
2 You could make the area safer by explaining the risks to Valda’s own safety and that of the care
workers. You could suggest moving the furniture so there is enough space for safe moving and
handling. Items that are not used very much could be moved into another room. Ensure that
the hoist is safe to use and that care workers are properly trained to use it. It is safer for two
care workers to move Valda in and out of bed. Make sure that Valda has everything that she
needs close to hand before you go, including a means of calling for help, should she need it,
for example a call alarm or a telephone.

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Unit 23 Develop your knowledge and practice
In the workplace: ‘Just a minute’ (page 101)
1 You could suggest that Alex relects on the incident using a simple relective cycle. You could
also suggest that Alex asks other care workers for constructive feedback on the incident.
2 No, the incident was not Alex’s fault. But Alex could have asked another care worker to help
him because he was busy dealing with another individual who was unwell.
3 If you were Alex’s work colleague, you could suggest to Alex that he:
• relects on the incident, and identiies areas of practice that need to be improved and what
he would do diferently if the situation were to occur again in the future
• calls for another care worker to help him, if this type of situation were to occur again in the
future.
In the workplace: How to help Linda (page 102)
1 Linda may feel like this because an individual with dementia attacked her in the past.
2 Linda’s past experience of individuals who sufer with dementia has been negative. These
negative past experiences are afecting Linda’s work because she avoids being involved in
the care of individuals with dementia and mental health conditions. This has also made Linda
unhappy about the manager’s decision to open more beds for individuals sufering with
dementia.
3 The manager could sit with Linda and discuss these problems with her. The manager could
reassure Linda that, by attending a dementia awareness training session, she will develop
a better understanding of dementia. By understanding the condition, Linda may be able to
develop her skills and ability to deal with situations that may arise when providing care for
people with dementia.
In the workplace: Training for all (page 103)
1 Sally’s manager is not treating her fairly because Sally has not been able to access any
additional training. She has only completed the mandatory training, while all the other care
workers have received a variety of training.
2 Sally may feel upset about being treated in this way because it would appear that she has
been treated unfairly and diferently to the other care workers.
3 Sally has the right to be treated the same as the other care workers. It is against the law to
treat Sally diferently because of her age, gender, religion, race or sexual orientation.
In the workplace: The annual appraisal (page 106)
1 Vera could use feedback from other people, and relective practice, to help her complete the
self-assessment form.
2 Vera could use a SWOB assessment to help her identify the skills she already possesses and to
identify the training that she needs to help her improve her practice.

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In the workplace: Is experience enough? (page 110)
1 No, Stella is not right to think this way. Even though she has been doing the job for ten years,
techniques change and new, improved skills are required. If Stella has not practised her skills
on a regular basis, she may not be able to provide the best possible care.
2 Stella’s attitude is putting the individuals who she helps to care for at risk of harm. If Stella does
not keep her skills up to date, she may be using old, out-dated, and dangerous techniques,
such as the‘underarm drag lift’. Stella is also risking the health and safety of herself and her
colleagues by not attending training sessions to update her skills.
In the workplace: What a pain (page 113)
1 Magda should not have given any of her own tablets to Mr Lem. Also Magda did not complete
the care plan accurately because she did not record the fact that she gave Mr Lem some of her
aspirin tablets.
2 Magda could have asked Mr Lem if he had any of his own tablets in the house, and
encouraged him to take his own medicines. If Mr Lem did not have any of his own medicines,
Magda should have recorded on the care plan that Mr Lem had a headache and that he had
refused his lunch. If Magda was worried about Mr Lem, she could have contacted her manager
for advice. Magda should not have given any of her own medication to Mr Lem.
In the workplace: Using new skills (page 117)
1 John’s work mates are inding it diicult to use the slide sheet because they have only used the
sheet once or twice and have not developed the skills to use the sheet efectively. To develop
their skills at using the slide sheet, they need to use the sheet more frequently.
2 To help his mates to develop their skills at using the slide sheet, John could suggest that they
call him when they want to use the slide sheet. He can then support them and ofer advice.
Or they could watch John when he uses the sheet. John could also suggest that they develop
their own individual slide sheet implementation action plans, to help and encourage them to
use the slide sheet on a more frequent basis.
1 The Codes of Practice for social care workers say that care workers are accountable for the
quality of their work and have to take responsibility for maintaining and improving their
knowledge and skills.
2 The purpose of appraisals and supervisions is to review the performance of an individual, to
identify their skills, strengths, weaknesses and to identify any additional training required to
help the individual to gain the knowledge and skills to do their job efectively and safely.
Each organisation will have its own way of arranging an appraisal or supervision, but the
process could include:
• asking or being asked by the manager for an appraisal or supervision date
• agreeing a time, date and place for the appraisal to take place
• completion of a self-assessment
• returning the self-assessment to the manager before the appraisal or supervision
• attendance at the appraisal, and discussion of your performance, including strengths,

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weaknesses, skills and training needs
• agreeing new objectives for the next period
• agreeing a review date to look again at the objectives.
3 Feedback is very important, whether it is formal or informal, and can be used to improve
practice. When people give you feedback, you will know if they like or dislike something you
have done. You can use this feedback to improve your practice by listening to the dislikes and
work out how you will try to improve these areas next time.
4 You can assess your own values, skills and knowledge by relecting on your practice and by
completing a SWOB assessment.
5 Organisations that can help you to develop your knowledge and skills can include:
• the organisation you work for
• colleges
• adult education centres
• awarding bodies, such as City & Guilds, SNVQ
• private training providers.
6 To help improve your own knowledge and skills you can:
• attend formal training
• read professional journals, newspapers and books
• search the Internet
• work-shadow someone who is more experienced
• listen to the TV and radio
• attend care conferences
• talk to other people doing their NVQ and your NVQ assessors.
7 You can make sure that you keep your skills and knowledge up-to-date by:
• reviewing your practice, skills and knowledge on a regular basis
• attending mandatory training
• attending supervisions and appraisals
• practising skills on a regular basis
• reading professional journals, books and newspapers
• attending team meetings.
8 You should go on training programmes to help you gain some of the knowledge and skills
required for you to do your job safely and professionally. Training can also help you to develop
your career.
9 The people who can help you identify the skills and knowledge you need to do your job and
to get onto the correct training programme may include:
• your manager
• your NVQ assessor
• your college tutor
• work colleagues
• training managers
• your internal veriier.

14
Promoting independence
1 You should give Zak some constructive feedback using the positive feedback sandwich. You
could start by pointing out what Zak has done well, before discussing the importance of
promoting an individuals independence and ofering choice. You might give examples of how
you do this within the scope of your own practice. Finally, you could point out some more of
Zak’s strengths, so that he feels valued and supported.
Back to school at my age!
1 Margaret’s manager has insisted on Margaret doing the NVQ Level 2 in Health and Social Care
because he can see the beneits of having staf trained to the correct level. The manager also
knows that they have to have a certain number of their workforce trained to the minimum of
NVQ Level 2 in Health and Social Care, and that the care inspectors may look at staf training
when the home is inspected.
2 The Codes of Practice for Social Care Workers state that,‘As a social care worker, you must be
accountable for the quality of your work and take responsibility for maintaining and improving
your knowledge and skills.’
3 Margaret may feel the way she does because of her educational experiences while she was at
school.
4 The college could support Margaret by being sensitive to her needs and reassuring Margaret
that she has the skills to do the job which she has been doing for the past 30 years. The college
could see what training Margaret has already received, and if this could be used as evidence
towards her NVQ. The college could also show Margaret a teaching room and explain that
schools and colleges are diferent now. Attitudes have changed since Margaret was at school –
teachers and tutors are much more supportive if someone is having diiculties.

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Unit 24 Ensure your own actions support the care, protection
and well-being of individuals
In the workplace: Helping Maud with her rights (page 125)
1 Maud has the right to have a choice over what happens in her life.
2 Her nephew may feel that Maud is safer where she is.
3 Maud may become even more depressed, and she may lose her independence.
4 As her care worker, you should do what you can to support Maud’s wish to return home. It
would be important to build up a trusting relationship with Maud, so that she doesn’t feel
that no-one is listening to her point of view. You should bring her situation to your manager’s
attention so she can be properly assessed.
In the workplace: Mr Flint – staff conflict (page 127)
1 Mr Flint has the right to have his food preferences respected.
2 Staf are concerned that Mr Flint’s diet may lack some nutrients, such as calcium.
3 Mr Flint’s preferences difer from what the staf feels is in his best interests.
4 If Mr Flint is not given food that he likes, he will eat even less and will lose weight. He may also
become angry because he is not being listened to.
5 As Mr Flint’s care worker, you could listen to his complaints and ind out what foods he does
like. Then communicate this information to the rest of the staf and record his preferences in
his care plan for other care workers to see.
In the workplace: Paulo’s problem (page 131)
1 Paulo has the right to be able to communicate in his preferred way.
2 Because of the language diferences, it may be diicult for care workers to talk to Paulo about
how he is feeling and whether anything is worrying him. Paulo may not have friends in the
area who could help care workers to understand what he needs. It may be diicult to get hold
of his records.
3 You could build a trusting relationship with Paulo by spending time with him. You could use
other communication skills, especially non-verbal communication. You could see if you could
ind an interpreter in the area.
In the workplace: Joseph’s personal care (page 133)
1 Joseph has the right to have his needs respected.
2 The other patients need to have their rights respected too, such as their need for sleep, and to
be able to eat in a pleasant environment.
3 Joseph may feel isolated and become depressed. Residents may become angry, tired and not
eat. This could cause conlict between Joseph, staf and other residents.
4 You should listen to everyone’s concerns, and use good communication skills so that the
residents know you are taking them seriously. Try to ind a workable compromise, such as
moving Joseph to a side room at night, with a care worker to help him.

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In the workplace: Gary is gay (page 136)
1 Gary is being discriminated against because of his sexuality. He could become depressed,
develop low self esteem or feel embarrassed. He may even wish to give up work, or decide to
leave that care home.
2 If Mrs Marshall complained to you, you could listen to what she has to say, but explain that
it is wrong to discriminate against Gary. You could politely point out that Gary is a good care
worker who puts a lot of efort into his job, and that it is good to accept diferences between
people. You should also inform your manager or supervisor about the incident.
In the workplace: Maureen’s opinions (page 141)
1 Maureen’s opinions might cause her to ignore the needs of the service users from diferent
ethnic backgrounds.
2 Maureen’s views could make it more diicult for Jane to treat all the service users equally.
Good teamwork could be diicult if Maureen makes it obvious how she feels about members
of staf from diferent ethnic backgrounds.
3 Having people from diferent ethnic backgrounds working at the care home should mean
there is a better understanding of the needs of service users from various backgrounds. This
will increase everyone’s knowledge and skills.
4 Jane could remind Maureen that we must not discriminate against individuals, that there are
beneits to having a multi-cultural society and workforce.
In the workplace: Cultural respect (page 142)
1 By making sure kosher food was available, Madhavi respected Joseph’s cultural needs.
2 Madhavi could ind out about Joseph’s cultural needs by asking Joseph, his family, the kitchen
staf, the Internet, looking in books, or by asking a Rabbi.
In the workplace: Rashid’s diet (page 144)
1 Rashid is being discriminated against because his cultural background and needs are not
being met.
2 As Rashid is not enjoying the food provided, and is losing weight, he could become
malnourished. He may not feel valued and may develop low self esteem. He could also feel
angry, especially as the other residents have a lot of choice.
3 If you were looking after Rashid you should speak to your supervisor or manager and explain
the situation. You could ask Rashid or his family if there are particular dishes that he likes and
see if you can get the recipes to give to the chef.
In the workplace: Unhappy Mrs Scott (page 147)
1 Mrs Scott is being discriminated against because information on the notice board is not
available in a way she can use.
2 Care staf could describe what is on the notice board, and read Mrs Scott the notices she is
interested in, or print out a large-print version that she can read. Ideally the board should be in
a position where Mrs Scott and other wheelchair users can read it.

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3 No, Mrs Scott’s poor eyesight means she will not be able to ill in the complaints form because
the print is too small.
4 You should listen to Mrs Scott’s complaints and help to exercise her right to complain by
helping her to ill in any forms. Inform your supervisor about the diiculties Mrs Scott is having
seeing the notices and ask if the complaints procedure could also be provided in a large print
version.
In the workplace: What’s going on? (page 150)
1 Caron was suspicious because she has known Mr Jarvis for ive weeks, and she has noticed a
change in his behaviour. He has now become quiet and withdrawn. This on its own does not
mean that he is being abused. It’s possible that Mr Jarvis is sad about something or is just
not feeling very well. Caron was right to note her concerns, although one or two symptoms
on their own do not always indicate abuse. You need to look at the whole picture. However,
several signs together may strongly suggest abuse.
In the workplace: Why won’t Janet join in? (page 150)
1 Sonia was concerned because Janet was quiet and withdrawn. Sonia may also have noticed
some bruising when she took Janet to change her trousers.
2 Janet could have sufered physical, and possibly emotional or sexual abuse.
3 Sonia should report her suspicions to her supervisor and make a record of them.
In the workplace: Don’t move Mrs Lang like that! (page 153)
1 The move is physically abusive to Mrs Lang because the care workers used an out-of-date
technique that caused Mrs Lang pain and injury.
2 Alison may have thought that it would be quicker to do this, rather than get the hoist.
3 Explain that it is wrong and abusive to move people incorrectly, and that the hoist is much
safer. Jane should also talk to her supervisor.
In the workplace: Mrs Jefferies’ terrible experience (page 155)
1 Mrs Jeferies was inancially, physically and emotionally abused.
2 Mrs Jeferies is upset, scared and worried about being alone in the house again. The incident
has reduced her self-esteem and made her angry.
3 James should report the incident to the police and to his care manager. He may need to let
other care workers know that Mrs Jeferies is feeling upset and vulnerable.
1 The Human Rights Act protects individuals because it:
• protects the right to life
• promotes the right not to sufer degrading treatment
• recognises the right to freedom
• recognises the right to a fair and public hearing
• recognises the right to marry

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• recognises the right to safety.
More information can be found can be found from the Oice of Public Sector Information at
www.opsi.gov.uk. Currently the Human Rights Act does not encompass people who are living
in independent care homes. This is an issue that is being addressed by government at present.
However, while it is not enshrined in law, there are‘moral’obligations on us all to support
people’s basic human rights.
2 The Care Standards Act promotes the rights of service users because, among other things, it
ensures that:
• service users’needs are assessed
• national minimum standards have been set
• care establishments are regulated, and regular inspections take place
• staf are CRB (Criminal Records Bureau) checked to see if they have a criminal record, to
protect vulnerable service users.
3 You can build a trusting relationship with service users by being friendly, approachable and
polite. Get to know the service users you work with as individuals. Value their opinions, be
sincere and show warmth.
4 Conlicts at work may include: service users wishing to do diferent activities; a service user
asking for a particular care worker, who is not available; medical conditions such as dementia
that can lead to challenging behaviour; smokers in a non-smoking environment or other
examples from a learner’s own work place.
When there are conlicts, care workers should listen to both sides and try to ind a
compromise, or solution. This should be recorded, so that other people know what has been
decided. The manager or supervisor might also need to be informed.
5 Discrimination may be because of: disability; race; culture; gender or sexuality; religion;
physical appearance or age.
6 Laws against discrimination include: The Disability Discrimination Act 1995 Amended 2005,
The Race Relations Act 1976 (Amendment) Regulations 2003; Employment Equality Act
(Sexual Orientation) Regulations 2007; Civil Partnership Act 2004; Employment Equality
(Religion or beliefs) Regulations 2003; Employment Equality (Age) Regulations 2003; Human
Rights Act 1998; Equal Pay Act; Disability Discrimination Act 1995.
7 Signs of abuse can include: depression; self-harm; bruising; lack of conidence; low self esteem;
fear; anger; suicide attempts.
8 Never ignore symptoms of abuse. Explain to the service user that you will only tell the people
who have to know in order to help them. Follow work place procedures, which should include
reporting and recording the incident.
9 Your Care Council’s Code of Practice discusses workers’responsibilities regarding abuse. These
include using proper procedures to challenge and report abusive behaviour, keeping people
safe, and taking steps to minimize the risks of service users harming themselves or others.

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Case Study (page 157)
The carers who really cared
1 The care staf showed respect for Mrs Brown in the way that they took into account
Mrs Brown’s wishes. When Mrs Brown could not talk, they found another way for her to
communicate her needs and feelings. The care team found out exactly what Mrs Brown’s
wishes were following her death and they made sure that these wishes were carried out. The
team made sure that she was not alone when she was dying.
2 The other resident’s were Mrs Brown’s friends and they were allowed and encouraged to be
involved in the care of Mrs Brown in the lead-up to her death. The scarf that was made by the
blind lady for Mrs Brown was welcomed, even though it had holes in it. Her thoughtfulness
was respected. The care staf involved the other residents and respected their wishes to say
‘goodbye’. The residents were also involved at the wake that was held at the home.

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Unit 214 Help individuals to eat and drink
In the workplace: Kelly’s shopping (page 167)
1 The food Kelly buys is high in fat and salt and contains very little vitamins and ibre.
2 Kelly could buy fruit and vegetables, even if these are frozen, as they are a good source of
vitamins and essential minerals, and they are not expensive.
In the workplace: Dorothy doesn’t like it (page 169)
1 Ilsa could ask Dorothy what she does like to eat. Ilsa could also ask Dorothy’s family for a list of
her favourite foods.
2 Ilsa could make sure this information goes into Dorothy’s care plan.
3 Dorothy’s physical needs are not being met because she needs to eat to recover from her
operation.
4 If Dorothy does not eat she may become anaemic and her body may not be able to heal
as quickly as it should. She could become constipated. If Dorothy does not drink she could
become dehydrated, which could make her ill and confused.
5 Ilsa could reassure Dorothy that they will try to provide food that she likes, (although the
kitchen might not be able to make Dorothy something diferent for every meal). Ilsa could also
explain that Dorothy needs to eat so that she becomes strong enough to go home again.
In the workplace: Sheena’s stroke (page 179)
1 Sheena may still ind it diicult to swallow her food when she gets home and she may feel self-
conscious about any dribbling. Sheena may ind it diicult to liquidise or puree the food.
2 Healthcare professionals, such as physiotherapists, occupational therapists, speech therapists
and specialist nurses, may be able to ofer advice and support. People from the stroke
association may also be able to ofer support and give advice.
In the workplace: Mr Smith (page 182)
1 Mr Smith may not be enjoying his food because urine bottles have been left on the over-bed
table and there is a nasty smell in the ward.
2 If Mr Smith does not eat, he may become weaker due to being undernourished. Mr Smith may
also become depressed because his basic human needs are not being met.
3 The urine bottles should not be placed on the over-bed table, but if they are they should be
removed and the table surface cleaned before mealtimes. If possible, individuals who need
to use the commode should be taken out of the ward and taken to the toilet. This will help to
keep the ward smelling pleasant.
In the workplace: Alvina’s advice (page 185)
1 Yes, Alvina didn’t know the answer so she was right to pass Oriana’s questions about
cholesterol on to her supervisor.
2 Care workers should not answer questions that are not in their job role, because the incorrect
answer could have very serious consequences for the service user. For example Alvina could

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have given the wrong advice and then Oriana could have eaten the wrong foods, increasing
her cholesterol levels.
In the workplace: Rose’s fall (page 189)
1 The care workers want to promote Rose’s independence so that she still feels that she has
some control over her life. It is Rose’s right to have this respected. It will build her conidence
and maintain her self esteem.
2 Rose could ind the following equipment helpful: a plate guard, easy grip fork and spoon,
rocker knife and a non-slip mat.
In the workplace: A sore mouth (page 190)
1 You might realise a service user has a sore mouth from: the service users’facial expressions;
the way they are chewing; the fact that they suddenly prefer to eat softer food stufs and avoid
more chewy foods.
2 If Sasha had not reported that Mrs Maxwell had a sore mouth, Mrs Maxwell would have
continued to lose weight. She could have become weak and run down.
In the workplace: Is Mr Lewis eating? (page 194)
1 The following records would monitor how much Mr Lewis is eating: his care plan, food and
luid charts and his weight chart.
2 The care staf are responsible for keeping these records.
3 It is important to keep accurate records so that there is a record of the service users’baseline
(normal) details. By continuing to record the service users’measurements, it is easier to
identify if there is any improvements in their condition, or if there are any problems.
4 Mr Lewis could feel weaker and have a low self-esteem because his basic needs have not been
met. Staf may feel worried because they could be disciplined for neglect of duty. The manager
would be accountable for the care given within the care home, which could lose business.
5 You should make sure that you record Mr Lewis’weight twice a week and encourage him
to eat and drink. You can encourage Mr Lewis to eat and drink by giving him the correct
equipment and trying to make mealtimes a social occasion. Finally, you should record all this
information on Mr Lewis’s care plan, luid and food charts, and any other relevant records.
1 A healthy, balanced diet should consist of a variety of diferent food, including fruit,
vegetables, cereals, bread, rice, meat, ish, nuts, eggs, dairy produce, small amount of fats and
oils.
2 You can ind out a service user’s preferences by asking the service user, their family, other
health care professionals and reading their care plan.
3 The ways a person’s cultural needs could afect their choice of food may include:
• Jewish people – may eat kosher food, beef and chicken, and may not eat pork, horse,
rabbits, shellish
• Hindus – may be vegetarian
• Muslims – may eat halal food and may not eat pork or drink alcohol.

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4 Food poisoning can be caused by poor food preparation, e.g. dirty hands, eating
contaminated foods, eating food past its use-by date, leaving food out of the refrigerator, or
food stored incorrectly in the refrigerator.
5 To help to prevent food poisoning:
• wash your hands before touching food
• wear an apron
• use separate chopping boards and knives for raw and cooked foods
• use food before its use-by date
• store food correctly in the refrigerator.
6 The reasons an individual may need help with eating and drinking include:
• weakness from a stroke that could lead to the loss of use of one arm
• problems with swallowing
• arthritic ingers
• broken or injured arm
• eating disorder
• badly itting dentures.
7 The following adaptive cutlery and crockery can help with eating and drinking:
• plate guard – for an individual with the use of just one arm
• weighted spoon – for someone with a tremor e.g. Parkinson’s disease
• rocker knife – for someone with the use of one arm
• easy grip cutlery – for someone with arthritic ingers
• cup with lid – useful for someone with a tremor or who has had a stroke.
8 Foods that can cause an allergic reaction include:
• strawberries, especially common in young children
• eggs, usually appears in very young children, most grow out of it by the time they are ive
years old
• shellish, may include ish and shellish, most common in teenage years and adulthood
• nuts, increasing number of children in recent years sufer from nut allergy, many foods
contain nuts that we are not always aware of, such as salad dressings.
All allergies could potentially be very dangerous and life-threatening.
9 If someone was choking you would remain calm, and try to keep the individual calm.
Encourage the person to cough. Ask them to lean forward, then slap them on the back to
dislodge the food. Abdominal thrusts should only be done by someone has been properly
trained to do them, and can cause injury. You will need to call an ambulance if the food cannot
be dislodged.
10 It is important to keep accurate measurements of a person’s intake so that changes can be
monitored more easily.

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Sammie
1 Healthy food choices Sammie could make include: low-fat and low-salt options (look on labels
to check for‘healthy option’); grilled foods; chicken; ish; baked potatoes; pasta; rice dishes;
vegetables; salads; fresh fruit; dried fruit; cereal bars; low-fat yogurts.
2 If Sammie continues to eat unhealthy food she could become very overweight (obese),
develop diabetes, heart disease or varicose veins.
3 Her care worker could talk to Sammie about how to make healthy choices, especially when
she is eating out. She may wish to take a healthy packed lunch that she could eat in the
cafeteria with her friends. Encourage Sammie to eat breakfast so that she is not tempted to
eat unhealthy snacks before lunch. The care worker could share her concerns with Sammie’s
teacher. The teacher may then include the importance of healthy eating as part of the
teaching for the group.
4 Sammie’s parents, key worker, care team, your manager, a dietician, nurse, or a teacher at
college could give advice on the best way to guide Sammie.
A hot summer
1 Maud became confused because she was not drinking enough and became dehydrated. It
was very hot so she would have needed to drink more than usual.
2 Jenny could have made sure that Maud had enough to drink. Finding a drink that Maud
enjoys, and ofering it to her regularly would make this easier. Jenny should have reported to
her supervisor that Maud was not drinking, then the care team would have been made aware.
A record of Maud’s input and output could be recorded. The rest of the care team could also
make sure that Maud was ofered drinks more regularly.
3 It is important to report problems straight away so that immediate action can be taken to
prevent a situation from getting worse. It ensures that others are aware of the problem, too. It
is also part of a care worker’s responsibilities to report problems and issues, to make sure that
service users are properly cared for.

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Unit 218 Support individuals with their personal care needs
In the workplace: Promoting continence (page 202)
1 Mrs Jafrey may have felt embarrassed or uncomfortable having a male care worker helping
her.
2 The care worker could make sure that Mrs Jafrey could call for help to get to the toilet in
time, or look at other means to help Mrs Jafrey to avoid wetting herself. The use of good
communication skills would show support and understanding of Mrs Jafrey’s feelings. If
possible, respect her wishes to have a female care worker. The supervisor should be informed
of the incident and Mrs Jafrey’s views.
In the workplace: Time of the month (page 203)
1 Kristin can use good communication skills to show understanding and support. Kristin should
be discreet, but explain that having a period should not stop Tammy enjoying herself.
2 Kristin can give Tammy advice about the feminine hygiene products available. She could
reassure Tammy that there would be adequate toilets there and suggest what Tammy should
take with her.
In the workplace: Mr Sharrock’s test (page 209)
1 Marina was right to test Mr Sharrock’s urine because she noticed the colour had changed,
which could mean Mr Sharrock had developed a health problem.
2 If Marina did not record what she noticed and the test results, there would be no record of
her actions. There would be no way to measure changes the next time Mr Sharrock’s urine
was tested. Another worker may repeat the test unnecessarily and it could lead to poor
communication between the staf.
3 Marina showed Mr Sharrock respect by involving him in decisions relating to his care, and by
keeping him informed.
In the workplace: What should Tom do? (page 213)
1 Tom should be honest and tell his supervisor he hadn’t measured Mr Jones’urine.
2 Tom’s carelessness could mean that information about Mr Jones’health was missing. But if
Tom did not admit his mistake, the wrong decisions could be taken about Mr Jones’care. For
example, he may have been prescribed treatment that he did not need.
In the workplace: Sunita’s angry husband (page 219)
1 Sunita’s husband is angry because he does not feel their religious and cultural beliefs are being
respected.
2 The care staf should have found out about Sunita’s needs, and this should have been recorded
in her care plan.
3 Sunita would probably prefer a female care worker, instead of Jason, to help her.

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In the workplace: Who can help? (page 224)
1 The occupational therapist’s role is to assess an individual’s physical needs and suggest ways
of maintaining independence.
2 Helpful equipment could include an inlatable bath seat, a bath board or other aids to help her
get in and out of the bath. A bottom buddy or toilet raiser can help with going to the toilet.
Adapted taps and non-slip mats could be useful too.
In the workplace: Caring for Keith (page 229)
1 Keith may not realise that he needs to wash, or he may be embarrassed about washing.
2 Good supportive communication could encourage Keith to have a bath. The care worker
would need to show sensitivity, so that Keith maintains his dignity and self-respect. Care
workers should be good role models, by making sure they have good personal hygiene
themselves.
In the workplace: Ethel’s choices (page 233)
1 The care workers want Ethel to wear appropriate clothes so that people do not make fun of
her. They also want to make sure what she wears is suitable for the weather, so that she doesn’t
catch cold or get too hot.
2 No, Ethel has the right to choose to wear what she wants even though it may not be the carer’s
choice.
3 Care workers can try to use good communication skills to encourage Ethel to wear more
appropriate clothing. They should also discourage other care workers from laughing at Ethel.
Have a go: Dressing and grooming aids (page 234)
Useful equipment includes: a stocking aid, button hook, an easy-reach, long-handled brush, a
long-handled shoe horn.
In the workplace: Saffron’s new jeans (page 235)
1 It is important to label clothes so that clothes and other personal items don’t get lost.
2 Safron could have become very upset if she lost her favourite jeans because they had not
been labelled.
1 Reasons why individuals need help with toileting and hygiene may include:
• recovering from operation
• recovering from an accident
• disability caused by a stroke, Parkinson’s disease or severe arthritis
• health problems such as dementia.
2 Toileting and bathing aids to help an individual remain independent include:
• a range of bath seats and boards
• raised toilet seats and risers
• bottom buddy

26
• urinals, convenes, commodes, bedpans
• grab rails.
3 A person’s cultural or religious background could afect the help you give them with toileting,
personal hygiene and dressing in many ways. Look on page 221 of the book for speciic
cultural examples, but they could include:
• the need to be cared for by someone of the same sex
• the removal of body hair
• the use of a particular hand for cleansing
• some people prefer to use running water
• the use of a bidet.
4 Changes from the norm could include:
• urine may become cloudy and smell ishy, which could mean infection
• faeces may become hard because of constipation, or runny due to diarrhoea
• changes in hygiene, i.e. if hygiene care becomes worse, it could mean that the individual’s
physical or mental health is also getting worse.
5 You can prevent the spread of infection by:
• good hand washing technique
• the use of gloves, aprons and other personal protective equipment (PPE)
• proper disposal of waste.
6 Problems relating to personal hygiene may include:
• a worsening condition, such as increasing pain from arthritis
• generally feeling unwell, for example the service user may have lu
• skin irritation
• mental health problems, such as depression
• general reluctance.
Problems relating to personal hygiene may be helped by:
• using good, supportive communication
• showing sensitivity to the individual’s condition and situation
• giving advice and guidance
• respecting personal choice
• recording and reporting the problems or diiculties.
7 Dressing aids include: the stocking aid; button hook; easy-reach; long-handled brush; long-
handled shoe horn.
8 You can help prevent the spread of head lice by:
• avoiding head-to-head contact
• using a repellent
• using conditioner and ine tooth combing regularly
• using the recommended preparations from a pharmacy
• using efective natural products that do not contain harsh chemicals.

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Mrs Clarke
1 It might be diicult for Mrs Clarke to accept Susan’s help, because she may consider Susan
to be very young. If Mrs Clarke had a family, or worked with young children, she might have
helped them at times if they wet or soiled themselves. It may not feel right for Mrs Clarke to be
the one needing support now.
2 It will help Mrs Clarke if the care workers act in a professional and sensitive way. They could
take time to talk to Mrs Clarke to ind out what her worries and concerns are, and to explain
that they want to help her.
The care workers should not look shocked, or show any distaste about any smell there
might be when changing the bag. Make sure that the care team are trained so that they know
how to manage Mrs Clarke’s colostomy, and can conidently help Mrs Clarke. When helping
with Mrs Clarke’s colostomy bag, they should make sure that the area is private. Allow Mrs
Clarke to do as much as she can for herself.
3 A specially-trained stoma nurse, practice nurse or stoma support group could help Mrs Clarke
with any diiculties with her colostomy bag.
Mr Palfrey
1 Mr Palfrey gets angry because his dementia means he does not realise that the care workers
are trying to help him wash or change his clothes. He probably genuinely believes that he has
already had a wash and changed his clothes.
2 If the situation is not resolved, Mr Palfrey may become angrier and become very aggressive.
He could even become violent towards the care workers. This could create a very diicult
relationship with Mr Palfrey. As care workers are beginning to avoid him, Mr Palfrey could
become neglected.
3 Jenny could spend time with Mr Palfrey, be very patient, and listen to him. She could use
good verbal and non-verbal communication skills to build a trusting relationship. He may
need more time than other people to think things through and to do things. She should be
prepared to repeat things over again, and not get impatient.
Jenny could involve Mr Palfrey’s daughter, as she may have found efective ways of
communicating with her father. If his daughter is aware of some of the diiculties the care
workers are having, she may not be so angry. The care team need training in dementia care.
This should be arranged as soon as possible, so they can help Mr Palfrey and other individuals
with dementia better. Dementia support groups can also give excellent practical advice.

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Unit 215 Help individuals to maintain mobility
In the workplace: Understanding Parkinson’s disease (page 249)
1 Students’own answer.
2 Answer could include: tremors (shaking), which may start on one side, then spread to the
other side of the body; tendency to stoop; not much facial expression.
In the workplace: Moving is painful (page 251)
1 Brian’s immobility could lead to the following:
• he could develop a chest infection
• his feet and ankles may swell
• he could lose muscle tone, lexibility and his joints could become stif
• he may develop deep vein thrombosis or a pulmonary embolism
• he may become incontinent, constipated or develop a urine infection
• he could get pressure sores
• he may feel more isolated and become depressed
• he may lose his conidence and independence.
In the workplace: Holistic needs (page 257)
1 If Ron doesn’t walk in the park, he could develop physical problems, such as muscle weakness,
weight gain or loss, stifness. Lack of exercise could eventually lead to more serious health
problems.
2 If Ron’s emotional needs are not met, he could feel isolated, depressed, demotivated, lose
conidence or become aggressive.
3 If Ron doesn’t mix with others, his social needs would not be met. His quality of life would
sufer through the loss of friendships.
Have a go: Care plan (page 258)
If you did not follow Daniel’s care plan, he could fall and seriously hurt himself.
In the workplace: Siân’s walking stick (page 264)
1 Siân’s walking stick may be too long for the service user. This could make the woman unstable
when walking, or give her shoulder problems. If the stick is too short, the service user could
develop back problems
In the workplace: The wet floors (page 267)
1 The residents could slip on the wet loor if they walk on it.
2 The hazard is the wet loor. The risks are that someone could slip on it and hurt themselves.
In the workplace: Gloriose is found out! (page 273)
1 If Gloriose knew she was being observed, she would have used her walking stick.

29
In the workplace: Betty’s fall (page 275)
1 The accident could have been avoided if Simon had listened to Betty when she said she was
tired. He could have asked her to rest for a while before carrying on.
2 When Betty was getting tired, she may have started to walk more slowly, she may have been
shaking, or breathing more heavily or diferently. She may have leaned more on Simon.
In the workplace: Lillian’s lack of progress (page 277)
1 Lillian may not be doing the exercises properly. She may need encouragement and support in
practicing the exercises. (Also see pages 268–269 in the book.)
In the workplace: Dragging his feet (page 279)
1 Gaynor should tell her manager that a service user is walking diferently, so that the service
user can be assessed to ind out the cause.
2 If Gaynor did nothing the service user might not have received the care he needed. Dragging
his foot could mean that he had had a small stroke, or it could be a symptom of another
medical condition that needs to be treated. Eventually his mobility could get worse, so that he
could no longer walk at all.
1 Bones support our body and act as a frame; muscles help joints to move; joints are where two
bones meet in a way that allows our body to bend.
2 The following conditions can afect movement: arthritis; cerebral palsy; muscular dystrophy;
brain injury; multiple sclerosis; stroke; loss of limb; osteoarthritis; Parkinson’s disease;
rheumatoid arthritis.
3 Problems caused by immobility include: chest infections; swollen feet and ankles;
incontinence; deep vein thrombosis; constipation; urine infection; loss of independence;
pulmonary embolism; depression; pressure sores.
4 The best ways to keep mobile are to have a little activity or exercise on a regular basis, such as
walking, gardening, housework, dancing or movement to music.
5 The beneits of keeping mobile are better breathing, less stifness, better circulation, feeling
happier, more independence, better skin condition, more lexible joints, stronger muscles and
more conidence.
6 You can identify an individual’s risks in mobilising by reading their records and care plan,
speaking to their physiotherapist or doctor, or simply by talking to the individual.
7 Care plans guide you in providing the correct care for that individual. Care plans are a legal
requirement under the Care Standards Act 2000.
8 Before using a mobility appliance you should check whether it is safe, clean, and belongs to
the individual who is going to use it.
9 You can support the use of mobility appliances by giving verbal and physical support,
encouragement and guidance.
10 You can observe individuals mobilising when they know you are watching them, or you can
observe when they don’t know you are observing them.
11 When mobilising, adverse reactions are unwanted results such as pain, sprains and strains, too

30
much shortness of breath, heart problems, asthma attacks.
12 You need to monitor an individual to check that progress is being made.
13 You should report and record changes in mobility to ensure the appropriate action is taken to
meet the individual’s changing needs. This could be because their mobility has improved, or
it might have deteriorated. Changes in mobility can also mean that there is a change in their
medical condition that needs attention.
Case study (page 281)
Norman
1 Arthritis is a condition afecting the joints of bones. Problems include pain, stifness,
inlammation and damage to joint cartilage (the tough, smooth tissue that covers the ends
of the bones, enabling them to glide against one another) and surrounding structures. This
damage can lead to joint weakness, which can make the individual feel unsteady. Sometimes
joints become swollen and deformed. This can make simple daily tasks such as walking,
climbing stairs, using a computer keyboard, cutting your food, getting dressed or brushing
your teeth very diicult and painful.
2 Taking the dog for a walk would enable Norman to maintain his mobility through simple
exercise, as well as helping him to feel good.
3 If Norman doesn’t keep mobile, his joints could become very stif and painful.
4 The information needed would be what Norman’s current abilities are, what he can or cannot
do for himself and what his likes and dislikes are. This information would be in his care plan.
5 You need to remember the Data Protection Act and conidentiality.
6 You must follow Norman’s care plan to ensure he receives the care he needs.
7 You could give Norman encouragement both verbally and physically. It is important for him to
continue with his exercises to enable him to stay mobile.
8 You can make sure the area is safe by ensuring there is no furniture that Norman could fall
over. The loor should not be slippery and there should not be any rugs or loose carpets.
9 At the end of each session you should record the progress Norman has made and any
diiculties he has had.
10 Keeping records after each exercise session helps to monitor Norman’s progress and to assess
if the exercises are suitable.
11 Any improvements or deterioration should be recorded and reported immediately to ensure
the care plan is altered appropriately, and that there are not any underlying problems.
12 When supporting Norman to mobilise, you will be following these legislations, policies
and procedures: Health and Safety; Best Practice; Human Rights Act; Equal Opportunities
legislation; Anti-Discrimination legislation; your organisation’s requirements.

31
Unit 223 Contribute to moving and handling individuals
In the workplace: Waheeda’s clothes (page 286)
1 No, Waheeda’s clothing is too loose and baggy, and her shoes have wedge soles.
2 Waheeda’s clothes could get caught in equipment, for example when she is using a hoist. She
could lose her balance or twist her ankle wearing wedge shoes.
In the workplace: Ansul’s lunch break (page 287)
1 Ansul should wash his hands before he helps the service user to walk to the bathroom.
2 He would normally wash his hands to prevent cross infection, but in this case it is also to
remove any grease from his hands, so that he can walk the service user to the bathroom safely.
3 If Ansul didn’t wash his hands, he could get grease on the service user’s clothes. Also the
service user could be ofended by the smell of ish and chips on Ansul’s hands.
In the workplace: Daniel’s care plan (page 288)
1 The changes in Daniel’s care plan are:
• Daniel has developed an infection at the site of his wound.
• the activity to minimise efects of immobility has been met and is no longer a nursing
requirement
• the target date to meet the safe use of crutches has been extended because of the infection
in Daniel’s wound
• a new activity has been introduced to exercise Daniel’s leg muscles.
2 If Graham had not read the new care plan, he may not have realised:
• Daniel had developed an infection in his wound
• Daniel is no longer being assessed for the risk of pressure sores. Graham would have wasted
both his and Daniel’s time if he had continued doing this
• a new activity had been introduced to exercise Daniel’s leg muscles. If Graham didn’t carry
out this activity with Daniel, it could take Daniel longer to recover from his injuries.
In the workplace: Jasmine and Samantha (page 291)
1 Jasmine should contact her manager, explain the changes and request an urgent
reassessment. Jasmine should not move Samantha until a reassessment has been done.
2 If Samantha’s mother had not said anything, Jasmine would have expected Samantha to
weight bear. This could have resulted in Samantha falling and hurting herself and Jasmine.
In the workplace: Too risky (page 293)
1 Jack could have hurt himself when supporting Louis to walk. Jack would have put additional
strain on his knee when walking with Louis, which could have made his knee condition worse.
Jack’s knee could have given way while he was walking with Louis, and then Louis could have
fallen and been injured.

32
In the workplace: Getting consent (page 294)
1 It is important for Faruke to obtain Manjit’s consent, to ensure that he is prepared and willing
to cooperate with the move. Gaining consent will also show that Faruke is treating Manjit with
dignity and respect.
In the workplace: Moving Blossom (page 296)
1 Blossom could be frightened of the equipment, or she could be afraid of admitting that she is
no longer able to help herself.
2 You could talk to Blossom and ask her what her fears are. You could reassure her that the
equipment is safe and show her how she will be moved in it. You could remind her that she is
still fully in control of the move, and that she can ask the care workers to stop the move for a
few moments whenever she feels she needs to.
In the workplace: Hayley (page 301)
1 The care worker will need to use a hoist to help Hayley in and out of bed.
2 This equipment is most suitable because Hayley is unable to support herself, as she cannot
stand. Without a hoist, the care worker would need to lift all Hayley’s body weight. This is not
permitted under Manual Handling regulations.
In the workplace: Joan’s fall (page 305)
1 Gayle should have ensured the walking frame was in position ready for when Joan had stood
up from the chair.
2 Alternatively Gayle could have called for someone to bring the frame to her or encouraged
Joan to sit back down while Gayle moved the walking frame into the correct position.
In the workplace: Looking after Petula’s skin (page 309)
1 If Petula was left in the same position her skin would start to breakdown because of the
constant pressure put on it. This would result in Petula developing a pressure sore.
In the workplace: Coordinating the move (page 313)
1 Kiernan should have said‘Ready, steady, move’, which is much clearer than using numbers.
In the workplace: Samuel is slipping (page 315)
1 Samuel is happy because he has become more independent and does not need to rely so
much on the care workers to be comfortable.
In the workplace: Out of reach (page 319)
1 Judith should have checked that she had moved all the furniture back into the correct
position, and that Melissa could reach everything she needed.

33
In the workplace: Supporting Harry (page 321)
1 If the problem had not been reported, Harry would have had diiculty getting out of his chair
on his own. This would have caused Harry distress and a loss of independence. Harry may not
have wanted to let anyone know that he was having diiculties, as he may have thought that
he was becoming a burden.
1 To prepare yourself for moving and handling you should ensure that you:
• are wearing suitable clothing and shoes
• are in good health
• have read the individual’s care plan
• have been trained to undertake the move.
To prepare the individual you should:
• make sure that you explain the move to them before starting it
• explain how they can help during the move
• keep explaining what is happening throughout the move
• give reassurance and encouragement.
2 It is important to read an individual’s care plan before you move or handle them because it is
your responsibility to know what care the individual requires and the way it is to be given.
3 Risk assessments tell you what problems can occur and what you should do to avoid them.
4 The types of conlicts you may come across are those where the care plan tells you to do
something one way, but the individual wants you to do something diferently. You should deal
with conlicts by talking to the individual and reporting unresolved conlicts to your manager.
5 You can check that moving and handling equipment is safe by making sure it has an up-to-
date safety sticker, checking that it is clean and that it is the correct equipment for the planned
use.
6 You can help individuals to change position by using a hoist if they are unable to help
themselves. You can support a move by using a slide board, slide sheet or handling belt.
7 You can actively support someone by giving them choice, showing them how they can help
you and themselves, and by providing them with the appropriate equipment.
8 You can minimise pain when moving individuals by ensuring you are properly trained;
involving the individual in the move wherever possible and by making sure the area is free
from furniture that could be tripped over.
9 It is important to restore the environment to ensure the individual knows where everything is
and that colleagues know where equipment is.
10 You need to observe and record changes in an individual’s moving and handling to ensure
that everyone caring for them knows the most up-to-date and appropriate care for the
individual’s needs.

34
Suki
1 Annette should follow Health and Safety – Moving and Handling regulations when she moves
Suki using the hoist.
2 Annette should check she herself is suitably dressed, has had the required training and is in
good health. She should also check Suki’s care plan, the hoist and sling.
3 Annette should follow the risk assessment and care plan, as it is a requirement. It also helps to
avoid causing harm or injury to herself and Suki.
Suki is upset
1 If the family didn’t have a spare sling, Annette should politely refuse to move Suki. She should
explain the possible danger of the sling falling apart, and causing Suki to fall out of it. She
should then contact her manager and report the diiculty.
2 Once Annette has inished getting Suki out of bed, she should write a full report in Suki’s care
notes on the problems she has encountered and the actions she has taken.

Answers To Questions In S NVQ Level 2 Health Social Care Easy Steps Unit 21 Communicate With And Complete Records For Individuals

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