UNDERSTANDING SPECIAL NEEDS IN HEALTH AND SOCIAL CARE

Introduction
In this essay the special needs in health and social care is carefully and extensively discussed. The aim is to understand what is meant by special needs, and how special needs are met in the health and social care system.
1.1 analyze concepts of health, disability, illness and behavior in relation to users of health and social care services
Disability is the body impairment both physical and mental that that limits one’s ability to do normal daily activities (Cockerill and Margolis (013). There are different types of disability such immobility, vision impairment, mental impairment, hearing impairment, etc. each type of disability present some form of challenges and unique needs to the affected person. For example, the care need for person with mental impairment may differ considerably with that of person with hearing impairment. It is therefore important for the care worker to understand all the aspect and types of disabilities so as to provide care services that are responsive to each patients needs. The impacts of disabilities are far reaching because they not only affect the person’s health but also make him dependant on other to survive.
According to world health organization, illness refers to a state of being physically, mentally and social unhealthy. As mention by Emson (1987), illness is may be short term in nature or be life time condition. A short term illness is the state of being unhealthy for a specific period of time after which the affected person makes full recovery. Long-term illness on the other hand is being unhealthy for life. The impact for illness may be similar to those of disability. The impacts of illness may be similar to those of disability. Illness limits one’s ability to carry on activities that he used to do before. Short term illness may cause temporary disability such as inability to walk, stand uprights etc. long-term condition normally cause lifetime disability. For instances, people with dementia causes mental impairment/cognitive impairment.
Behavior issue arises when the person’s behaviors are not in line with the culture or norm. When such behaviors put the life of other and that of affected person in danger they are termed as challenging behavior .Example of challenging behaviors include hitting, kicking, wandering, hair pulling, and throwing object among others. Behaviors issues are caused by brain damage and mental unhealthy (Ogunremi 2010). The impacts of behavioral issue are the same with those of disability and illness. People with behavior issues are unable to perform activities essential for supporting one independent living.
Disability, illness and behavior issue all have one common characteristic. They all limit one’s ability to live an independent life. People affected by these three conditions thus require special care.
1.2 assess how perceptions of specific needs have changed over time
Perceptions toward disability have changed overtime. Unlike in the ancient time, people with disability are treated and perceived positively in the modern times. During the ancient timem there was no scientific information to defined disability, illness and behaviors issue. Religious view especially those from bible was used to attach meaning to these three conditions. According to Friscella (2000), people with disability, illness and behavioral issue were seen as posed by evil as per the Christian teaching. They were humiliated, oppressed and ignored by the society. However that gradually changed and by industrial revolution era, they were seen as object of mercy that deserved welfare. The societies build home for them and increased charity work aimed at helping them (Barnes, 2007).
That has however ever changed. In the modern time, people with disability, illness and behavioral are no longer seen as object for charity works. They are perceived as individuals capable of doing anything that a human being can do. This perception has been reinforced by legislation, policies and also by technology. In the last few decades, legislation and policy to promote the rights and the place of people with special needs in the society has been enacted. Such laws include the UN convention on the rights of people with disability which is implemented through the human rights 2008, the equality acts and several others. Advancement in technology has also enable people with disability perform activities that was initially seen as impossible. This has also change people perception about the capability of people with special needs.
1.3 analyze the impact of legislation, social policy, society and culture on the ways that services are made available for individuals with specific needs
Legal frameworks have been put in place to ensure people with special needs receive the services that are non-discriminative, and responsive to their needs. Several legislation has been enacted while other has been amended to ensure that people with special needs receives the right health and social care that is effective .for instance the health and social care 2008 established the care quality commission to ensure the standard of services offered by health and social care provider are of the required standard to support service user. The care Act 2014 has devolved some of the health and social care services to local authorities. The Acts requires community to be consulted in designing health and social care services to meet their own needs. This Act makes the health and social care services more user led.
As mentioned by Armenakis, and Kiefer (2007), Culture also does affects the way people responded to health and social services. Some culture may promote the use of health and social services while other, though few, discourage the use of health and social services due to reason such as religious belief. Some culture attaches a lot of stigma in the use of health and social care services scaring their members away from the services. The civilized cultures on the other hand promote the use of health and social care services when someone is unhealthy.

2.1 analyze the care needs of individuals with specific needs
The care need for people with special need is many and diverse. According to Duck, et al., (2012), the care needs of people with special needs vary from one person to the other. However some are more common to all than other. In our two case scenario, baby coronel and Mr. HL, both of them has some similar care needs while at the same time has different care needs. They both needs physical needs such as food, shelter etc which is essential for survival. Besides that, baby Coronel is also in need of safety. The baby needed protection from abuse he was going through. However this was not adequately provided. Hl on the other hand needed emotional and family support.
We can draw one conclusion from then discussion above. Care needs for people in health and social care are many, diverse and may be unique to each person. Care services therefore need to be personalized to meet each individual’s needs.

2.2 explain current systems for supporting individuals with specific needs
The current system to support individual with special need is made of two categories the public health system and the private health system. The public health care system is provided by the NHS. In the NHS system, the primarily care is provided by general practitioner who then referrer service user for further specialized services where necessary. General practitioners are the first contact in the line to offer support to people with special needs. After GP, there are other health specialist and institution that provide specialized care. These specialized services include NHS dentistry, Optician, pharmacies, specialized hospitals among others
Under the NHS system, there are other health agencies. Clinical commissioning group is one of the notable one.CCG is responsible for commissioning health and social care services in NHS. They do this after carrying out health and social care need assessment in the local community in conjunction with local authorities.
The NHS system provides services free of charge at the point of delivery. Funding in this system is done through public fund collect through taxation.
The private health system on the other hand, comprises several health and care institution which include mental clinics, community pharmacies, health care clinics and hospitals among other. Unlike the public sector, health and social care services in private sector are provide at fees.

2.3 evaluate the services available in a chosen locality for individuals with specific needs
There are several services to support people with special need provided by Havering council. The council has a stand by occupational therapists that provide special needs assessment and advices on what should be done to help individual life more independent live. The team is also responsible for helping people with disability modify their home to meet their care needs or facilitate their relocation to other suitable house.
In addition, the council also proved transport services to people with special needs. Older people and people with disability are issued with freedom pass card that allow them to access public transport free of charge. People with learning disabilities are also offered training on how to travel independently. The council have partnered with Disabled Association of Barking and Dagenham to travel people with learning disability to prepare and plan for travel, personal safety and road safety. (havering.Gov.uk, 2015).
3.1 explain the approaches and interventions available to support individuals with specific needs
Through legislation and policies provided by the department of health, the government has ensured that the rights approaches are used in the health and social care services. These approach include evidence based practices, self help,
Evidences based practice involves the use of technique, method and strategies whose effectiveness has been scientifically proven. The National instate of care excellence, is the government’s agencies constituted to ensure proper guideline is provided to help care provider identify and use the practice that has been scientifically proven to be effective.
Self help- this refers to ability of the patient/ services user to take care of their condition. As mentioned by (Duck, et al., 2012) due to the increasing number of people who are in need of care as a result of increase in long-term condition, self help has become an integral approach in the health and social care. Self help is an approach that involves educating services user on how to effectively take care of self.
Choice approach –in the delivery of health and social care services, the choice of service user is always taken into consideration. This approach is meant to ensure health and social care users are satisfied with services delivery.

In order to meet the diverse needs of people using health and social care services several intervention are used .the use of these intervention do however depend on the special needs of each individual. The mostly used interventions are therapies and treatment. Therapies used can be classified into drug therapies and non-pharmacological therapy. Drug therapies are the use of medication to treat disease. In this intervention, the health care professional assesses the health and wellbeing condition of the services user and then prescribe Pharmaceutical drug to be used. The role of care worker in this intervention is to ensure services user under their care do take the drug in the right quantity and the right time. As prescribed by the health professional/general practitioners. Non-pharmacological is a term used to refer to a wide range of strategies other than drug therapies that are used to manage and treat special needs in health and social care service (Care search, 2015). Non Pharmacological intervention can be classified into three categories i.e. Physical, cognitive and behavioral therapies. Physical therapy is the treatment of disease using physical techniques such as massage, exercises, acupuncture, transcutaneous Electrical Nerve Stimulation etc. Cognitive therapy is a therapy that focuses on challenging the negative though about self and the world with the aim of altering the unwanted behavior. It is mainly used for treatment of psychological problem such as anxiety, depression, loneliness and the likes. Example of cognitive-behavioral therapy includes relaxation, distraction, meditation, prayers, and yoga among other (Yurdanur, 2012)
3.2 evaluate the effectiveness of intervention strategies for an individual with specific need(s)
There is enough study that show the effectiveness of the two interventions discussed above. Scientific evidence has shown that Drug therapies are most effective in treatment of long term pain. However their side effects may be severe. according to (LLS, 2013), drug therapy can result to side effects such as fatigues, headaches, hair and nail loss, fertility complication, dental issue among other. As noted by Yurdanur (2012), over reliance on drug therapy to treat special need can also cause drug resistance which reduces the effectiveness of the intervention. However as majority of the side effect are temporary in nature and they gradually disappear as one body adjust to the treatment.
According to Yurdanur (2012), Drug therapies are most effective in treating the somatic i.e. the physical and emotional side of pain. While non-pharmacological therapies are very effective in treatment of cognitive, affective, behavioral and social cultural aspect of the pain. Unlike drug therapy, there are no severe side effects associated with non pharmacological intervention.
Despite the side effects associated with drug therapies, the intervention is effective and widely used. The benefits derived from these interventions outweigh the side effects. However it is important to notify the services user of possible side effect before the therapy is used on them

3.3 discuss the potential impact of emerging developments on support for individuals with specific needs
The future of health and social care services to support individual with special needs is taking shape courtesy of the recent development in the sector. The recent reorganization of NHS system has already started to change the way health and social care services are provided. The new reorganization had devolved some health and wellbeing responsibility to local authorities and local health agents such as health and wellness board, and clinical commissioning group. This move has made it possible to involve communities in the matter of health. This is a positive trend in making NHS services more user lead health and social care system. The personal health budget which has been introduced recently as part of the overall reorganizations not only give people with special need financial support they much needed but also allows them to choose what health and social services they feel are right for them. This budget will increase services user satisfaction and also result to improve effectiveness of care services as people will be able to pay for the most appropriate services.
The care act 2014 is the latest piece of legislation that will affect the future delivery of health and social care services. Put a limits on the amount of money adult with eligible needs spend to purchase care services. This will force local authorities and health and social care service provider to designed more cost effective services. The aim of this cap is to prevent misuse of fund or exploitation by service provider. The acts also put statutory obligation on local Government to duty and power to meet the care need. This Acts also establishes two authorities which is the health education England and the health research authority. These two agencies will be responsible for gathering and dissemination scientific information necessary in making health and social care decision. Available of information will not only help people with special need make more wiser decision but will also help them self manage their condition (LGA, 2014)
4.1 explain different concepts of challenging behavior
We a person’s behavior is out of norm or is socially unacceptable it is termed as challenging. Behaviors is termed as challenging if it cause harm to self and onto other and if it prevent a person from fulfilling some activities of life such as going to social event, schooling (scope.org. uk). People understanding of challenging behavior have changed over the recent years. A few decade ago, the person showed challenging behaviors was seen as the problem to fix. However, recent understanding of challenging behavior which has been reinforced by social model disability, suggest that challenging behavior is a sign that something is not working properly as expected. In this new understanding, it is the not the individual that needs to be fixed but the surrounding environment (Scope.org.Uk). According to Ogunremi (2010), behaviors are used to communicate unmet needs or problem in communication. Challenging behavior may be classified as;
Self injurious- This is behaviors that are directed to causing harm to self. They include, head banging, and eye poking, hair pulling etc
Aggressive behaviors e.g. kicking, hitting, spitting verbal abuse, throwing object among etc
Stereotyped behavior such as repetitive comments, repetitive manipulation of thing etc
Non-person centered behaviors- these are behavior that are not directed to a specified person. They include, wandering, stealing, property destruction, undressing in public, among others.
The impacts of challenging behavior are severe and they affect wide range of people from the person himself, to family, care workers, other resident/ service user in health and social care setting. Aggressive behavior may cause physical harm to others while stereotyped behavior may cause psychological harm. Self injurious cause physical and mental harm to the person himself while none person –centered behavior may cause damage to property
4.2 describe the potential impact of challenging behavior on health and social care organizations
Care providers are greatly affected by challenging behaviors in their facilities. As mentioned by Skill For Care (2013), challenging behavior in health and social care facilities need competent staffs whose skill are up to date. Care organizations are thus required to hire and train their staffs in management of challenging behaviors. Staffs who are not competent enough may cause the behavior to be more rampant that the usual way.
A survey conducted by Alzheimer’s Society in care home revealed that challenging behaviors cause distress among the staff as well as in other residents ( Alzheimer’s Society 2015).This may affects the quality of services delivery be the care organization as it is well known about the connection of staffs motivation and performance.
4.3 analyze strategies for working with challenging behaviors associated with specific needs
To manage challenging behavior effectively and to minimize their negative impacts on health and social care facilities, health care organization need to employs the rights strategies. In the line of principle of health and social cares services, strategies adopted should be based on effectiveness, choice, and in best interest of affected person. As noted by Ogunremi (2010), partnership working in the management of challenging behaviors is essential in achieving effectiveness. Care worker, behavior specialist, the servicer user or his/her family, the general practitioner and the management of the care organization should all work together in devising and implementing the appropriate strategy.
As mentioned by Ogunremi (2010), challenging needs are unique to each individual in term of frequency of occurrences, trigger, and their impact. The strategies adopted should therefore be personalized to meet the unique care needs of the affected person.
Where possible, the affected person should be empowered to self-manage his condition. For example, a person who experience cyclical challenging behavior may be educated about his condition and how to manage it. He should be help to identify the presiding symptoms and how to avoiding the behavior from occurring. This can increase the effectiveness of the strategies as well as promote more independent living.
The strategies employed should also be based on the choice of the affected person or that of his/her family. Where it is impossible to get the node of service user or that of his/her family, the strategies employed should be in the best interest of the patients as required by mental capacity act 2005.The needs to observe the choice of the services user is well demonstrated by the HL case scenario. The Burne wood hospital’s action of detain him without his approval or that of his care taker was ruled to be against the law.

Conclusion
This essay has examined special needs in health and social care setting. From the finding in here, there are system, policies and approach that are designed to respond to the need of people with special needs. In every aspect of support for people with special need, legal framework work exists. Government policies and legislation enacted by the parliament play big role in ensure appropriate services are to support people with special needs are in place. It is therefore to keep this policy and legislation under review to ensure they are responding to the prevailing needs of service user.

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