Manage risks in conflicts between individual rights and duty of care

3.2 Explain how to manage risks associated with conflicts and dilemmas between an individual’s rights and the duty of care

Course: NVQ Level 4 Diploma In Health And Social Care (RQF)

Unit 9: Professional practice in health and social care for adults or children and young people

LO3: Understand how to address conflicts and dilemmas that may arise between an individual’s rights to choice and control and the duty of care

In health and social care, we may find ourselves presented with situations where a person’s autonomy is at odds with the obligation for caregivers to protect them from injury. Managing the risk these situations pose requires a systematic, person-centred approach.h

1  . Conduct a Risk Assessment

The first step p the assessment of risk with respect to the choice made by the individual. Consider potential harm to the person, others, and the environment. If a person with a cognitive impairment chooses to undertake a certain task alone, we must assess the actual risk to them, or put another way, compare the risk to their safety against their right to independent living. The Level 3 framework of assessing and consulting, balancing, consulting experts, and planning would be helpful in this context of a risk assessment. 

2. Promote Informed Decision-Making

Next is the requirement that we engage the person in meaningful and clear communication regarding their choice. What is their choice, and can they convey the potential risks and benefits of their choice in a way that can be understood? It is important that the individual has all of the necessary information available to them to be able to enable their autonomy, but also for them to appreciate the implications of their choice.

3 . Apply Care Plans and Follow Procedures

Always refer to existing care or support plans and organisation policies. Often, staff will use care or support plans that have agreed risk strategies that direct your interventions. 

4. Mitigate Risk Through Practical Strategies

Recognise steps that can be put in place to reduce risk, without choosing to deny choice. An example includes if someone refuses medication for anxiety, the true choice is to delay the request and then perhaps try to carry out the request later, or if they are reassured and their anxiety is settled, it is the same request with a different outcome. Throughout, you can be sure to “do what you can to help them make an informed choice and reduce the risk. 

5. Seek Expert Guidance and Use Relevant Tools

If capacity is unclear, refer for a Mental Capacity Assessment, according to the Mental Capacity Act. When in doubt, refer to managers, safeguarding leads, or health professionals, particularly when the choices could result in serious harm.

6. Document Thoroughly

Keep thorough records of conversations, decisions, risk assessments, and subsequent actions. This ensures not only accountability, but a chance to inform future care and be open and honest. 

7. Learn and Reflect

Once you have worked through a dilemma, to determine whether the criteria have been met, think back. What tactics worked? What would you adapt if faced with a similar dilemma? This is valuable for professional judgement, and ultimately, future risk management.