The CARE CERTIFICATE

Privacy and
Dignity
What you need to know

Standard
THE CARE CERTIFICATE WORKBOOK
 Privacy and
dignity

Two important values when

providing care and support are:

 Privacy: giving someone space where and when they need it

 Dignity: focusing on the value of every individual, including:
 respecting their views, choices and decisions
 not making assumptions about how they want to be treated
 working with care and compassion
 communicating directly with the individual whenever possible.
The safeguarding and wellbeing of
individuals are very important. As far as
possible, you should get to know each
individual; their background and ideas,
wishes, likes and dislikes. You should
always provide personalised care and
support that puts an individual at the
centre of their care. You should enable
them to be as independent as possible
and respect their privacy and dignity.
Working in this way reduces the risk of an
individual being treated in a way that is
degrading or harmful.

Privacy of information

Part of providing good care and support involves building trust and confidence and
having the best interests of individuals in mind. Take great care not to discuss personal
information where others might overhear or by using too loud a voice. Personal information
includes things like their health conditions, sexual orientation, personal history or social
circumstances. Individuals may tell you other private information that they trust you to keep
to yourself. Unless it is necessary to pass this on for health and social care reasons you
should keep this confidential. That will have the added benefit of it helping to build trust.

Confidentiality is a very important right of individuals who receive care and support.
Information should always be shared on a need-to-know basis only, for example with other
workers involved in their care. You should not share information with anybody else, even
the person’s family or friends, without their permission. For example, an individual may not
want a friend to know about their health or if they have been unhappy.
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There might be occasions when an individual
does not want to share information that you
feel is important for other workers to know
to be able to provide good quality care and
support. It is important that you explain this
to the individual concerned, giving your
reasons. Try to find agreement over the level
of information they are willing for you to pass
on. If you still feel that this is not in their best
interests, talk to your manager about the
dilemma you are facing. They will help you
judge whether you should tell the individual
that you must pass something on in the best
interests of their care and support.

Privacy and dignity in care and support

Individuals should always feel safe and comfortable. Talk with them or look at their care
plan to find out how they want to be treated in different situations. In particular, it is
important to find out how the individual would like their carer, family members or friends to
be involved or kept up to date about their care and support. They may want to be totally
responsible themselves for passing on information or about how far they want to involve
them in their personal care or life. You should respect and support them in their choice
which will sometimes involve having to sensitively challenge the assumptions that others
have made.

Each individual has a different view of what they see as their personal space so it is
important to find out from them what is comfortable for them. In general these are some
examples of ways that you should protect their privacy:
 always ask individuals before touching
them in any way
 knock on the door or speak before you enter
the particular space or room they are in
 if your role involves supporting
individuals to wash or dress make
sure you protect their dignity and
privacy by making sure curtains,
screens or doors are properly closed
 clothing or hospital gowns should
always be arranged in a
dignified way
 if someone needs support to go to
the toilet they should not have to
wait or be left too long for you to
return.

In each workplace, issues about privacy

and dignity will vary so make sure you
understand what they are by talking with
other workers or your manager.

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Making choices

To promote the dignity of all individuals they should be fully involved in any decision that
affects their care, including personal decisions (such as what to eat, what to wear and
what time to go to bed), and wider decisions about their care or support.

Choices can only be made if people have information. If they know the options, the risks
and possible implications they can make the choice that is right for them. This is ‘informed’
choice. Sometimes decisions are difficult even when an individual has all the information
available. There are a number of ways that you could help the individual to make informed
choices. You can explain information, find people who can share their experiences or ask
for the help of specialist workers. It might also support them to involve other people they
trust, like friends or relatives. An advocate might be an additional option to help someone
to make a decision where they need additional help to understand and consider their
options and the risks.

Sometimes an individual may not be able to understand and retain the information they
need to make a decision or communicate their choice. If this is the case they may lack the
mental capacity to make the decision.

The individual may be able to make day-to-day decisions, for example what to wear and
what they want to eat, but not able to make complex decisions - for example, about money
or medical issues. In situations where you are not entirely sure about the individual’s
capacity, please seek additional advice or guidance.

Risk assessment
When looking at options that you are helping a person make decisions about, risk
assessments are a legal requirement and will give clear guidance on how to keep
people safe and prevent danger, harm and accidents. Every individual should have a
risk assessment as part of their care, support, rehabilitation or treatment plan. This will
have information on the person’s daily care and support, for example personal hygiene or
mobility, and how best to protect them and others from harm.

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A risk assessment contains information on possible hazards to do with the care and
support provided and steps that need to be taken to control any risks.

The Health and Safety Executive (HSE) propose five steps to risk assessments:
1. Identify the hazards.
2. Decide who might be harmed and how.
3. Evaluate the risks and decide on precautions.
4. Record your findings and implement them.
5. Review your assessment and update if necessary.
(www.hse.gov.uk/risk/controlling-risks.htm)

If a new activity is going to be introduced, the fives steps of risk assessment must
be followed first.

Everyone’s choices are shaped by things like their

background, values, culture, religion or similar
beliefs (if any), education or past experiences.
Equally, everyone has the right to weigh up and take
risks that they believe will make their life enjoyable
and worthwhile. As a worker you can give your
view if the decision affects their health or social
care, but it is the individual’s right to make a choice
and take any risks once they understand all the
information available and are fully aware of the risks.
Risk enablement involves supporting individuals to
identify and assess their own risks and then enabling
them to take the risks they choose.

The person-centred approach in health and social

care tries to involve the individual in the planning
of their care and support as much as possible.
However, there might be times when someone is
unhappy with decisions that have been made on
their behalf or with the choices they are offered. If
this is not within your power to change you should
tell them about their right to complain and support
them to follow the complaints procedure.
Supporting active participation

Active participation is a way of working that supports an individual’s right to participate in

the activities and relationships of everyday life as independently as possible. The individual
is an active partner in their own care or support rather than being passive. The individual
is the ‘expert on themselves’ who knows best the way of life that matters to them, and
the worker must listen and take this into account at all times. For example, when it is a
birthday or a special occasion, the worker must ask the individual if and how they would
like to celebrate rather than making assumptions or telling others about the occasion
without their permission. Taking control of their own care and support helps an individual
build their identity and self-esteem. You should also keep equality and diversity in mind,
giving every individual an equal opportunity of achieving their goals, valuing their diversity
and finding solutions that work for them.

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Selfcare

The ability to have control and care for oneself contributes to privacy and dignity. Skills for
Care and Skills for Health have developed the Common Core Principles for Self Care. The
purpose of the principles is to enable all those who work in health and social care to make
personalised services a reality. They put people at the centre of the planning process, and
recognise that they are best placed to understand their own needs and how to meet them.
You can find the principles at www.skillsforcare.org.uk/selfcare

When working in health or social care you need to be positive, open-minded and show
respect for other people’s attitudes and beliefs, especially when they differ from your own.
Your job is to care for the physical, emotional and spiritual wellbeing of an individual and
allow them, as far as possible, to live their life the way they choose or to get back to the
best health possible to allow them to do this.

Prejudice and stereotyping have no place in health or social care and should always be
challenged. Reflecting on your own attitudes and beliefs is crucial to making sure that you
do not allow them to affect your quality of work.

Stereotyping
To have an opinion about a group and applying this to anyone belonging to this
group, for example, “No woman can park a car”.

Prejudice
This could mean to not like someone just because of the group they belong to.

There will be times when you face problems about how you can provide the best care and
support and need to ask advice from others. It is important that you share any concerns
about privacy or dignity with your manager and always follow your agreed ways of working.

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The CARE CERTIFICATE

Privacy and
Dignity
What do you know now?

Standard
THE CARE CERTIFICATE WORKBOOK
 Activity 7.1a

In relation to care practice,

describe what is meant Describe - To to describe
describe means
means toto create
create a
by the terms privacy and a picture
picture with
withwords
wordsbutbut
not
not
simply
simplywriting
writing
dignity. a list of bullet points.

Privacy is...
About keeping information confidential. It can also be ensuring an individual has time
and space to themselves if they wish to.

Dignity is...
About not making assumtions. Respecting an individuals views and opinions even
though they may not be your own. Working with care and compassion.

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 Activity 7.1b
As a healthcare support worker or
adult social care worker, you will
be providing care to individuals who
have a range of different needs,
wishes and preferences and in
situations which may be sensitive,
personal or challenging. In the
table below, list situations where an
Describe: to describe means
individual’s privacy and dignity could
to create a picture with words
be compromised and then for each
but not simply writing a list of
one describe how you would maintain
bullet points. Include details
their privacy and dignity. An example
like why and how.
has been provided for you.

Situations when an individual’s privacy and Describe how you would maintain the
dignity could be compromised individual’s privacy and dignity in this
situation
1. When entering the space, bedside, The code of conduct for healthcare support
cubicle, room, home that an individual is in workers and adult social care workers
states that I must gain consent before
providing care and support to an individual.
Therefore, I must always make my
presence known and ask if the individual is
happy for me to enter the space they are in
2. Consent must be gained prior to supporting
When assisting with personal care. an individual with personal-care. Covering
the individuals private areas where
possible. Closing doors to ensure privacy.

3. Healthcare workers must respect the

If an individual asks to have some "private wishes of the individual so as they can have
time". some undisturbed alone time.

4. This is the individuals private and

If an individual doesn't consent to their confidential information. It cannot be
information being shared with their family. shared without the individuals consent.

5. I need to help the individual maintain their

If an individual needs assistance whilst independence and dignity as much as
using the bathroom. possible. I am there to support them and
must not do everything for them.

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 Activity 7.2c
It is essential that you do not
disclose anything about an
individual that they wish to
be kept private, unless it is
appropriate to do so. Explain why
this is so important. You could Explain - to explain something you will
include the aspects of a person’s need to provide a clear account of your
life in the grey boxes in your understanding including details like why
answer. and how.

Health condition Sexual orientation Personal history

Social circumstances

As a support worker I have access to a lot of personal information about the

Individuals I support. This can Include on-going health conditions or their personal
history. They may not be proud of some of the things that they have done in their
past. They may fear being treated differently due to their sexual orientation. Even
though it is illegal to do so under the Equality act 2010. Social circumstances can
also be a cause embarassment for some. I must keep this information private and
confidential unless I have the individuals permission to share this information. Some
time because of mitigating circumstances I may need to act In the individuals 'best
interest' and share this information.

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 Activity 7.3a

There are a number of ways

that you can help individuals
to make informed choices.
Describe three different
ways in the boxes below. An Describe - To to describe
describe means
means toto create
create a
example has been provided a picture
picture with
withwords
wordsbutbut
not
not
simply
simplywriting
writing
for you. a list of bullet points.

We can only make informed choices when we are

given all the information that we need to make a
choice.
1. Provide as much information
as possible

Weigh up the pro's and cons It is important that we support the individual to
for the different choices that make a choice. We must explain the possible
can be made. consequences for each of the available choices.
2. There are also potential benefits to each choice.

Talk to professionals The individual may understand their options better if

they are explained by a professional that
specialises in that area. This could be a DR if the
3. individual doesn't want to take their medication.

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 Activity 7.3b & c

Risk taking, risk assessment

and risk enablement are three
terms that you should be
familiar with as a care worker.
Familiarise yourself with these
terms and answer the two
questions below.

1. How can risk assessment be used to support the right of individuals to make their
own decisions?
All of us take risks. If a risk assessment is carried out then it will identify potential
risks. With a risk assessment it will show how to reduce a risk or even eliminate it
completely. The individual will then be able to make an informed choice.

2. Why must you ensure that your personal views do not influence an individual’s
own choices or decisions?
It is important our own views and opinions effect or influence an individuals decision
or choice. It is important that we are all different and we should value and respect
othe people's views, opinions and beliefs.

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 Activity 7.3d

Part i) For each of the

statements below, decide
whether you need to support Describe - To to describe
describe means
means toto create
create a
the individual to question or a picture
picture with
withwords
wordsbutbut
not
not
simply
simplywriting
writing
challenge the decision. a list of bullet points.

Would you support the

individual to question or
challenge the decision?

An individual has been transferred to a new service

or situation without being informed of the change ✔
YES NO

An individual has consented to being referred to a

YES NO
speech therapist for support after a stroke

An individual’s diet plan has been changed but they

are not sure why
✔
YES NO

Part i) Thinking about the statements above, describe why you would need to support
individuals to question or challenge decisions made about them by others. Include the
following in your answer:

Confidence Self-esteem Person-centred care

Empower

It is my responsiblity to support an individual to question any decisions made about

them if they have not given their consent to any changes. This will empower the
individual, boost their confidence and their self-esteem. Working with the individual
this way ensures that they are at the center of their care and ensures that healthcare
workers provide person-centred-care.

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 Activity 7.4d
As part of your duty of care, you have
a responsibility to support individuals
to question or challenge the decisions
that are made about them by others,
especially if these decisions have
been made without their involvement
or consent. For the two examples
below, state how you would support Describe: to describe means
the individuals to question or challenge to create a picture with words
the decision and also describe how but not simply writing a list of
you would report your concerns to a bullet points. Include details like
relevant person. why and how.

Describe how you would

State how you would report any concerns
support the individual you have to the relevant
to question or challenge person (this could include
the decision a senior member of staff,
carer or family member)
I would ask the individual if I would document the side
they would like me to assist effects and the individual's
Example 1: An individual them in making an response. I would then
tells you that their appointment with their G.P. report this to my manager or
medication has been I could then if they wished team leader so as they could
changed and they are assist them to them to take the appropriate action.
experiencing side effects; discuss their views and
they think this is because opinions to their G.P.
of another pre-existing
condition.

I would ask the individual if I would document everything

they still want to use the that has happened and what
Example 2: One of the service. I would remind the was said. I would the inform
individuals you support service provider of their my manager or team leader.
who has dementia has responsibilities under the
been declined access Equality act 2010 as this
to a service or activity explains discrimination of
as it is believed it may disabilities. I would also
cause unwanted negative use the services
emotions.
complaints procedure.

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 Activity 7.5a, b & d

Valuing the individuals you

care for and support makes
a very important contribution
to encouraging active Part ii) Complete the table below to show how
participation. you can support active participation for the
individual involved:

Why is it important
Explain how you Why is it important to enable the
would enable the to enable the individual to
individual to make individual to maintain their
informed choices develop skills in own network of
about their lives self-care? friends within their
community?

I would give the It is important that It is important that

A young ex-
individual all of the the individual the individual
serviceman is
being rehabilitated relevant information develops the maintains their
in hospital so as they can make necessary skills in network of friends as
after receiving an informed self-care to maintain this will maintain their
significant trauma decision. I would their dignity and own identity and
to both legs. He also seek specialised promote their promote their
is soon to return advice from health confidence and inependence.
home to his wife professioanals and self-esteem.
and children
support groups that
with support of
will have indiviuals
an occupational
therapist to ensure who have previously
his home is experienced similar
equipped with the situations.
correct services
to continue his
rehabilitation. Prior
to sustaining his
injuries, he was
engaged in many
social activities
and enjoyed sports
such as basketball
and surfing.

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 Activity 7.5a,
b&d
Part ii)
Describe the importance
of how valuing individuals,
such as the one above,
helps to contribute to
and encourage active
participation. You could use Describe - To to describe
describe means
means toto create
create a
the example to help you a picture
picture with
withwords
wordsbutbut
not
not
simply
simplywriting
writing
describe your points. a list of bullet points.

It is important to value people as individuals because this will mean that you respect
their views and opinons. This also means that you see them as a person. Their care
will then be person-centred. By encouraging them to make decisions for themselves
with support will promote their independence and empower them . They will be more
confident in their own abilities and do more for themselves. They will actively
participate intheir own care and support.

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 Activity 7.5c

Complete the diagram

below to list other ways you List - this term means to identify the
can use to support active main points which can be written as
participation. bullet points

Ask their opinion.

Support the Active listening.

individual to find
solutions to achieve
the desired outcome. Ways to
support active
participation could
include...

Respect their choices.

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 Activity 7.6b

Self-awareness and reflection

is an essential part of your care
Reflection: reflection is the process of
practice and being aware of thinking about your experiences in an critical
your own attitudes and beliefs way to explore what you could do differently,
can help you to make sure improve on or remember for next time. A
the quality of your work is not reflective account could include:
affected negatively. Produce a  What happened?
 What went well?
written account to show how  What didn’t go so well?
your personal views could  What could you do to improve?
restrict the individual’s ability to  How will you put this into practice
actively participate in their care. next time?

It is important not to let my own personal views, beliefs or attitudes influence my

work. I should not discriminate against anyoune because of their gender, disability,
race or religion. I may be averse to risks in my own personal life. I must not prevent
an individual from taking a calculated risk. They have the right to make unwise
decisions. My personal views should not interfere in any way.

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