Block 1 Key Points

Carers are family members who provide care for another person who is sick, unable to manage daily life unaided Governments are interested in family care because, without family carers, providing care can be prohibitively expensive It is important to indentify carers so that help, and in some cases financial support, can be provided However, it can be difficult to identify carers because; much of what happens in families is private; many people resist being labelled as a carer or a cared for person; it can be hard to measure how much caring someone does;some caring is reciprocal - there is give and take; and more than one person may be invovled in caring Care relationships can be stressful and demandng The quality of the relationship between the person which is cared for and the carer is influenced by the dynamics of the family life, past and present Lack of information about alternatives, and a sense of duty is often means that family members do not feel they have a choice about taking on there role of carer It often takes a crisis before people ask for help The case study is not typical, but there are many families in a similar position The majority of carers are women, and most people care for are older The experience of caring varies when the people are at the receiving end are young people, but there are many common themes Although caring has long been done within families, it is only became a matter of public interest in the late twentieth century In some communities in the mid-twentieth century, care was accomplished by a netwook of family members living near to one another, Daughters usually took the main responsibilty for caring Changes in the way families live has led to caring becoming less of a shared responsibility between family members However, there is little evidence that families have rejected the idea that they have a responsibilty to care for family member as they grow out and frail, but smaller families and greater distances mean that the types of contact has changed

We tend to think of illness as something wrong with a person's body However, illness also has social and moral aspects, because it affects how you play your part in life around you. To deserve the 'privileges' of being ill, plus are expected to fulfil the obligations of the sick role Illness has a psychological aspect too. people read their bodies signals differently and react to them differently. Recognising illness involves coming to terms with the personal consequences of taking on the sick role The term primary care refers to all health care services which people can access directly Most primary care is provided though primary health care teams, made up of GP's and a variety of other health care professionals, plus administrative staff A visit to a GP provides a first point of contact with the health services The medical world has its own distinctive culture, which is different form most people's everyday lives, so a doctors surgery can be an unsettling environment A condition such as diabetes has lifelong consequences for  the person who has it, and requires a major commitment to participation in self-care For common chronic diseases there are usually networks of support within the community To be effective, health care needs to take account of the service users perspectives Health care for long term conditions needs to be attuned to the cultural background of the service user It also needs to take account of the services users ability to afford a prescribed programme And it needs to take account of the service users psychological reactions to illness and to treatment Successful health care for long term conditions involves more than health care professionals applying the biomedical science. It also involves engaging service users as partners in thir own care programmes THis includes supporting them in becoming expert patients who can take an active part in understanding and managing their own care. Health is not s straight forward concept. It involves minimising disease and maximising psychological and social well being. Levels of health are affected by biomedical advances and also by social changes, such as income levels, quality of housing, diet and pattern of exercise As Society changes, the paternalistic relationships of traditional biomedical model of health care are giving way to partnership and support for patient expertise Recent government policy supports these less hierarchical forms of health care relationships Government policy aims to break down barriers between hospitals and community care shifting acute care, where possible close it the everyday world of the service useer Recent trends in diabetes care ( as promoted by the National Service Framework for Diabetes) provide excellent examples of these government policies in action.

It is important to understand why carers may take a long time to recognise their own needs and ask for help Before accessing home care services, users and carers need to undergo an assessment of needs. This will set out what they are entitles to expect in a care plan Home carers work to the care plan. Users are not able to direct their work beyond that Support form others in a similar situation is often critical to carers well-being Specialist services are often available, but not necessarily widely known about Aids and adaptions to the home can be of incalculable assistance to people with disabilities of long term health conditions In reality, care services are unlikely to be able to provide for all the needs of people and their carers. Publicly provided social care services are not universal - to qualify for them people usually need to be at substantial or critical risk The boundary between health and social care is difficult to draw, but hotly contested  because health care is free to users where as social care is not Long-term or continuing care in increasing seen as social care rather than health care, meaning that the costs fall on individuals Local variations can mean a 'postcode lottery' for both quality and the cost of care. Although the aspiration is for services to maximise independence for care recipients ac carers , in practice this is rarely achieved because of lack or resources.  Home care workers provide  vital service in enabling people to stay in their own homes when they have care needs Home care workers work to a care plan which determines what they do for each client Home care workers need to manage relationships with clients so that there are clear boundaries between being friendly and being 'a friend'. At times this makes considerable emotional demands Personal qualities are important, but not enough. Home carers need technical skills too. People value home care that is reliable and flexible, and which is delivered with kindness and with respect for then as individuals Providers of home fare are commissioned by public bodies usually local authorities Recruitment, management and training of well motivated staff is core to the provision of high quality care However well managed, home care agencies struggle to provide the care to their clients want and need in the context of cost constraints set by commissioners and managing competing demands from large numbers of clients Although individual workers often give excellent service, there have been many criticisms of home care delivered by agencies Direct payments, in which people who use services hold the money and choose and pay their own personal assistants, are a way of changing the power relationship between users and workers in home care People who have direct payments report much greater satisfaction than people who use more traditional home care services. Workers as well reported greater satisfaction, and less stress. Personal assistants are low paid and lack opportunities for training and career progression. Direct payments may be more suitable for some groups of service users than others.

A care relationship is a special kind of relationship which needs to be set up and maintained Good quality care practice is promoted in the UK through the National Occupational Standards, by bodies of practice and by regulatory bodies. The important but rather overwhelming documentation produced by these bodies is boiled down for the purpose of K101, to five key principles of care practice By Viewing examples of care practical and applying theses five principles you have developed skills in: observing and assessing care practice; indentifying evidence of good and bad practice, recording what you observe and reflecting on your own practice

Unit 1

Unit 2

Unit 3

Unit 4