Block 4 Key points

ople and organisations can resist institutional practix=ces and avoild the negative effects of institutionalisation Encouraging independence and supporting people's rights may invole responsible roisk takingHome is often a place for care Ordinary housing often presents physical barriers for people carrying out everyday activities and caring for others The design and layout of the home environment can make it inaccessible - 'a disabling environment'. Adaptations tot he home can help to remove barriers and make it a more enabling environment continuing to live at home - if its accessible - is good for peoples health and well being Home maintenance and improvements are often required over time as peoples needs for care and support change. Definitions of disability can vary depending on who is doing the defining The social model of disability says that people are disabled as much by their environment and by society as they are by their impairments The social model identifies environmental, attitudinal and structural barriers that limit peoples lives Housing needs should be considered alongside health and social care needs Appropriate housing is crucial if people are to live integrated lives in society. Hospitals vary in design and layout, some being more ;enabling' than others the hospital is a social and psychological environment as well as a physical one A hospitals allocation and use of public and private space can affect the power differences between patients and staff the working lives of staff are affected by the conditions in which they have to work Involving patients and staff in discussing hospital building can lead to improvement in design Care homes come in all shapes and sizes; cedar court is very different form Sonlai gardens Negative Institutional practices can occur in all kinds of care homes People and organisations can resist institutional practices and avoid the negative effects of institutionalization Encouraging independence and supporting people's right may involve responsible risk taking

A transition is a change or a series of changes, a turnign point brough about by life course changes or a key life event. Leaving home is a major life transition A sense of connectedness provides the continuity that helps children and adults cope with transitions in their lives Home is a physical, social and psychological environment People become attached to places, including the place they regard as home Losing one home may be experienced as a bereavement and people need opportunities to manage the transitionWhen people leave home they begin to form new attachments to people and placesDaily transitions in health and social care require regular and frequent adjustments and re-adjustments between people and settings. This requires planning and support form carersIn some circumstances, leaving home can be traumatic experiencePeople often go through a series of stages when adjusting to a major transition Good practice in supporting people through key transitions in their lives includes proper preparation and introductionA 'special' setting or category in health and social care may mean speration from everyday lifeSome health adn scoail care settings convey negative messgaes about osme poele who use them ( for example young people without family supprt and peple with mental health problems) and those who work for themCare setting can be seen as 'spaces of transition' where people are contained during a phase of their livesAcquiring a label such as 'special needs' or ;autism' can mean a lifetime of perate provisionsDisabled children and adults face additional transitions as they move bewteen places ads well as through life stages Some of life's transitions can b anticipated and planned for Planning often involves families as well as the person making the move Care setting can be designed to support people through transitions as well as having a beneficial effect on health and well being The social environment - how people are welcomed, looked after and cared about - can help people to cope psychologically with major changes in their lives.

institutions emerged in the nineteenth century in response to wider social changes They targeted particular people with problems or where thought to pose a problem to society Institutions continued into the second half of the twentieth century and smaller-scale versions exist even now Institutions may be characterized by negative institutional practices and these can lead to the process of institutionalization Smaller care setting - or sub cultures within homes - can also take on some of the more negative institutional practices Extra care housing is an alternative to residential care It combines independent living with person center care and community support The physical environment can be designed to offer access, privacy, choice and safety Extra care housing has the potential to be person-centered, flexible and culturally sensitive Care homes come in all shapes and sizes; cedar court is very different from sonali gardens Negative institutional practices can occur in all kinds of care homes People and organisations can resist institutional practices and avoid negative effects of intitutionalisation Encouraging independence and supporting people's rights may involve responsible risk taking The workforce is predominately female and half of the care workers are part time. They tend to be poorly paid, in low status jobs where there is high turnover Person-centered care can only be delivered by trained, motivated and vauled staff Training , supervision and support are important for ensuring good practice in care settings Bureaucratic structures can hinder person-centered care, while activities that enable people to see and represent themselves as distinct individuals can promote it

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