OP F5 Implement interventions with older people at risk of falls

Overview

This standard is about working in partnership with older people and their carers, to implement interventions in the context of their agreed individualised care plans to reduce their risk of falls. It covers confirming the nature, purpose and goals of the interventions, implementing the interventions and monitoring the outcomes. In the context of this standard older people are those with a history of recurrent falls or those assessed at increased risk of falling. Interventions will be implemented as part of a multifactorial intervention programme focused on the individual’s particular risk factors. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. the legislation which relates to your work including: health and safety, confidentiality and information sharing, the provision of services, the rights of older people, anti-discriminatory practice, capacity and consent, single assessment process, relevant mental health legislation and care programme approach
2. the professional standards and codes of practice for your area of work within older people’s services and how to interpret and apply these
3. how to manage your responsibilities and accountabilities as a professional with organisational and contractual requirements
4. the nature, aims, objectives, values, policies and systems of the organisation in which you work
5. your own values, beliefs and attitudes, and how they could impact on your work
6. the nature, extent and boundaries of your work role and its relationship to others in the organisation
7. the roles of other health and social care practitioners and how they relate between and across agencies
8. the ethics concerning consent and confidentiality, and the tensions which may exist between an individual’s rights and the organisation’s responsibility to individuals
9. the rights of individuals to make decisions for themselves and to take risks in the context of their own lives
10. methods of obtaining valid consent and how to confirm that sufficient information has been provided on which to base this judgement
11. the actions to take if the older person withdraws their consent
12. how to recognise when individuals are not able to exercise their rights to make informed choices
13. the legal framework for making decisions for, or acting on behalf of, an older person without capacity, and how the best interests of an older person without capacity should be determined
14. the situations when consent may not be required e.g. under relevant mental health legislation
15. how to deal with issues of confidentiality and who has the right of access to information that has been recorded
16. why it is important to clarify with the older person whether they need and have carers, and to confirm with the older person whether they accept their carers as having any say over their care
17. how to communicate effectively with older people and their carers
18. the possible impact of the ageing process on older people’s communication needs e.g. vision impairment, hearing impairment, cognitive impairment, speech and language difficulties, confusion, dysphasia
19. the ways in which carers should be involved in communication in order to deliver the most effective outcome for the older person
20. the type of communication and relationship difficulties that may occur with and between older people and their carers, and what to do to overcome them
21. the importance of working in a facilitative and enabling way and how to do this
22. the importance of focusing on the older person as an individual
23. the importance of respecting the different backgrounds and values of older people and their carers
24. how to present information in ways which are appropriate for different people
25. the effects of environments and contexts on communication (particularly institutional settings)
26. the ways in which communication can be modified and altered for different needs, contexts and beliefs
27. the main issues, debates, and policies relating to the health and well-being of older people
28. the guidance that is available for you own practice, and the sources of the guidance
29. evidence based practice, and its role in improving services
30. the main trends and changes relating to the health and well-being of older people
31. the ageing process and how it may affect the needs of older people
32. the main health conditions that may affect people as they age
33. the important distinction between chronological ageing and age-related conditions
34. the drugs and interventions which are used to manage the main age-related conditions and the effects of these on the overall health and well-being of individuals
35. how to seek advice on conditions and drugs
36. the impact of social relationships and environment on the health and well-being of older people
37. how the needs of older people may affect others
38. the importance of being alert to signs of possible abuse or harm to older people
39. what to do if you suspect an older person may be the victim of abuse or neglect
40. the intrinsic and extrinsic factors associated with falls and the relative impact of these
41. the possible physical and psychological effects of falls on older people and those who care for them
42. the interventions that are effective in minimising and managing the risk of falls
43. the medical conditions that increase the risk of falls
44. the importance of prompt diagnosis and treatment of underlying medical problems
45. how factors in older people’s lifestyles can affect their risk of falls
46. the measures that can be taken by older people and their carers to prevent falls
47. how to ensure that interventions are delivered as part of a co-ordinated, comprehensive and non-stigmatising service for older people
48. the previous and present interventions that the older person may have experienced
49. the purpose of agreeing goals for the intervention at the start
50. the ways in which personal beliefs and preferences, including cultural or religious beliefs, may affect the intervention options open to individuals
51. how to identify the levels of understanding that older people and their carers have of the proposed interventions and any possible side effects
52. the importance of encouraging older people and their carers to ask questions, seek advice and express any concerns about interventions
53. the roles which older people and their carers need to take if the interventions are to be successful, and how to explain and agree these with them
54. the information which it may be necessary to share with others and how to make sure that the older people and their carers are clear about this
55. the environments in which interventions take place and the assessment of risk
56. how to prepare equipment, materials, work area, and yourself for the interventions
57. methods of using different interventions within your area of practice
58. how each of the interventions may be modified, consistent with evidenced based practice, in order to achieve a successful outcome
59. methods of encouraging older people and their carers to work as active partners in implementing the intervention
60. methods of enabling the older person to be as comfortable as possible and maintaining their dignity and privacy given the constraints of the particular intervention and the setting
61. the particular risks which specific interventions may have
62. how to monitor the effect of different interventions and evaluate their efficacy
63. methods of establishing when interventions should be halted
64. when to seek advice and refer to other professionals
65. the local protocols for accessing, consulting and referral to other professionals
66. how to complete and structure records and reports so that they contain all of the essential information and are suitable for others to use
67. the importance of effective record keeping in accordance with professional guidelines and local policy, and the procedures relating to this.

Performance Criteria

You must be able to do the following:

1. explain clearly your role and its scope, your responsibilities and accountability
2. establish an open and supportive relationship with the older person and his/her carers as identified and agreed by them
3. communicate with older people and his/her carers in an appropriate manner, and encourage them to seek clarification of any procedures, information, and advice relevant to them
4. explore the needs and expectations of the older person and his/her goals for the intervention
5. identify current or previous interventions that the older person may have experienced and the immediate requirements of his/her individualised care plan
6. obtain the valid consent of the older person for the actions to be undertaken on his/her behalf, and agree the information which may be passed to others
7. discuss and agree the role of the older person and his/her carers in achieving the goals of the agreed intervention
8. make arrangements for the intervention that are consistent with the older person’s priority and his/her specific requirements
9. ensure the environment used for the intervention is suitable, and that the privacy and dignity of the older person is protected
10. implement the intervention in a safe and effective manner, using evidence based practices and processes
11. implement the intervention in a manner that is consistent with the older person’s needs and specific requirements, and encourages their effective participation
12. minimise any discomfort to the older person within the constraints imposed by the intervention method
13. encourage the carers to give appropriate support to the older person throughout the intervention
14. monitor the effects of the intervention on the older person throughout the process, and identify any indications of increased risk
15. take appropriate action where the effects of the intervention are not as beneficial as expected
16. work in partnership with the older person and his/her carers to assess the outcomes of the intervention in relation to the goals agreed at the outset
17. produce records and reports that are clear, comprehensive, and accurate, and maintain the security and confidentiality of information

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard has indicative links with the following dimension within the NHS Knowledge and Skills Framework (October 2004). Dimension: HWB7 Interventions and treatments