1.1 When going into a call the first thing that should be done is to get all the materials that you need together in order to provide care. For example, if someone is bed ridden and you are changing their pad then you will need to get the clean pad, carrier bag, toilet roll, baby wipes, towel, cream if applicable and usually the slide sheet ready. By not having everything ready you will have to stop what you are doing and go and get things. The individual during this time is rolled on their side and no doubt in some discomfort and delaying the proceedings to go and get things only increases this discomfort. After providing care all materials should either be disposed of or put away ready for the next use. Any soiled clothing or bedding should be changed and put into the washing machine ready for the next wash. When preparing food all dirty dishes should be washed, dried and put away so that they are ready for the next use and all kitchen surfaces should be wiped clean. Any foods that have been opened should be stored correctly either in the cupboard or fridge so that they do not go off and can be used again.
1.2 It is important that team members work together in the management of the environment and resources. The carers who go into the homes and provide care need to be considerate not only of the individual but also of the next carer who is going into that call by leaving the environment ready for use. Care managers need to respond immediately to any problems to ensure that carers can continue with their work without delays.
1.3 Any problems with the environment should be investigated to the extent that no harm comes to the person doing the investigation. For example , if the problems are related to something such as gas, or electricity then the gas or electric board should be called immediately as interfering with this could cause harm. If the problem is something minimal such as changing a light bulb than this can be done as long as no harm can come to the person changing it. For example, if the light bulb can be reached whilst standing on the floor then it is safe to do so but if it requires step ladders or a chair then further assistance is required. All problems should be recorded in the care plan and reported to the care manager.
1.4 The impact of environmental changes on resources including their storage and use largely depends on the setting in which these resources are being used. For example, in hospitals and nursing homes, there are specific storage rooms, refrigerators’ etc which are temperature controlled at all times and therefore do not specifically undergo environmental changes. However, in individual’s homes environmental changes have a greater impact as the impact as the ability to control certain factors such as storage is reduced. An example of this would be if pads were kept in a shed outside due to lack of storage space in the home. This would be fine in the summer months but once the temperature started to drop damp could set in making the pads wet and non-useable. Another example would be where certain medication was prescribed which needed to stored in the refrigerator. If it is not kept refrigerated it may not work as well as if it had been.
2.1 With regards to preparing environments, medical equipment, devices and resources for use during healthcare activities the health and safety measures relevant to the healthcare activity and environment are as follows: Wearing gloves, aprons and masks when necessary Ensuring that there are no objects in the way which can cause harm, Ensuring all medical equipment, devices and resources are functioning correctly and if they are not report the problem and not use them. Ensuring the equipment, devices and resources are still relevant to the individual e.g. if eye drops were prescribed for use over 5 days are the still required. Ensuring that all equipment, devices and resources are to hand before starting the healthcare activity.
2.2 Gloves and aprons (where necessary) are worn during all calls involving personal care and food preparation. Different gloves should be used for personal care and food preparation to avoid cross contamination. Gloves and aprons should be disposed of at the end of each call. Hands should be washed on entering and leaving each call and after smoking and eating. Hair should be tied back if it is mid length or long. Tissues should be used if coughing or sneezing and disposed of and then hands should be washed.
2.3 The main conditions that affect individual comfort within the environment are warmth, lighting, food and cleanliness. With regards to warmth it is important to ask the individual whether they are comfortable especially in the winter months when the thermostat may need to be turned higher up. A change to the blankets on the bed will be necessary according to the seasons and particularly in winter a blanket over them while they are sitting in the chair or a hot water bottle may be required. Lighting is more often than not unchangeable and it is important to ensure that light bulbs work. I do care for a lady who felt that the lighting in her front room was to bright so we brought lamps down from of the spare bedrooms to create a softer feel to the room which she is now pleased with. Food is extremely important in affecting individual comfort as we all need to eat and drink and we also like to have snacks to eat between meals or while watching TV. We can ensure that the fridge is stocked up with foods that the individual likes to eat and, if they have mobility problems, leave snacks out for them within easy reach. The same applies to drinks with regards to cleanliness, most people like to sit in a room or lie in bed in which the immediate surroundings are tidy and clean.
2.4 The main resource that I am personally responsible for are gloves and aprons. I can ensure that these are available in advance of planned healthcare activities by ensuring that I have a sufficient supply at all times with regards to essential resources within the individuals home I can ensure that these are available in advance by keeping my eye on stock levels and where levels are running low then advise either the individual, their family or the care manager that stocks need reordering. It is the duty of myself and my colleagues to report any shortages immediately.
2.5 Medical equipment, devices and resources should be checked before they are used each and every time they are used to ensure that no malfunction can harm the individual who is using them or on whom they are to used. Any defects should reported immediately to the care manager and the equipment not only used but put out of the way of the service user who may not understand or realise that there is a problem. If a defect is noted it is important to leave clear instructions for colleagues both in the care plan and also by putting a sign with the equipment, devise or resource so that it can be easily be seen.
2.6 Any problems with medical equipment, devices and resources would be immediately reported to my care manager who would then look into the matter.
2.7 Refer to 2.5 above.
2.8 Clinical governance is the term used to describe a systematic approach to maintaining and improving the quality of patient care within a health system. Resources are prepared in line with clinical governance by following the standard codes of practice as described in unit 201- preparation to work – 1.1 and also unit 208 preparation to work -1.1.
3.1 It is important to ensure that the environments are ready for their next use as it ensures that the area has been left clean and tidy. It also ensures that the next carer who comes in to the call does not have to spend time cleaning up the environment before they can begin their work. For example, if an individual needs to use the commode desperately it is not acceptable for the carer to have to tidy up or move things out of the way that the previous carer left before the individual can use the commode.
3.2 The factors that influence the readiness of environments for use in healthcare activities are as follows:
How the previous carer left the environment.
How mobile the individual is.
Whether the individual lives alone or with family.
Whether supplies/equipment has been ordered and is there.
3.3 All equipment must be cleaned and stored correctly once they have been used so that the next colleague can use them straight away. For example, when giving someone a bed bath, the bowl used must be cleaned and rinsed and put back in the place it is stored. Flannels and towels must be put into the washing basket or directly into the machine ready to be washed. Razors must be rinsed and checked to ensure that any unsafe or worn blades are removed and disposed of. If clean blades are needed then these should be put on ready for use the next day.
3.4 Used, damaged or out-of-date items should be disposed of immediately. With regards to soiled pads and catheter bags these should be placed in a carrier bad and disposed of in the outside bin. Damaged items should be removed from the property as they can cause harm to the individual if they continue to be used (the individual may not be aware that something is damaged). Out-of-date items such as medication should be placed in the bin out of the service users sight/reach as the medication may have changed and out-of=date items are no longer in use. Taking the wrong medication can cause serious harm to an individual’s health.
3.5 Un-opened and surplus resources should be returned to the correct location for storage so that they are not in the way. Leaving them lying around can be a hazard for an individual with regards to mobility, for example , boxes of pads left in the hallway . It also ensures that all opened items are used first.
3.6 It is important to monitor levels of consumable materials used in healthcare activities so that the individual does not run out of things which they need on a regular basis. Examples of things which need to be monitored are pads, creams, catheter bags. Whoever orders these supplies, such as the individual themselves, their family or the care manager, need to be advised in advance so that they can get the order in before supplies run out.
3.7 Consumable materials are replenished by either advising the individual, or their family (or whoever does this for them) what they need more of, or advising my care manager of the individuals requirements. This does not always happen of course. I care for a man who is bed ridden and we visit him four times a day. We use baby wipes when changing his pad in order to ensure that he is clean, however, he never has any wipes as his family don’t bother with him. The office has been informed on a number of occasions yet still the family do not provide what is needed. It is often the carers who will provide these as it make our job very difficult not having them especially when he only has one flannel which we use to wash his body in the morning.
3.8 All information is accurately recorded as specified in local protocols in the care plan. For example under the heading “household duties” I always state that the pad has been correctly disposed of. If additional supplies are needed I enter this in the “comments” box and state who I have advised.