Case Study 1

Jackie is a care worker in a supported living facility for those with severe learning difficulties. Holly is a 45-year-old woman with severe learning difficulties who cannot communicate verbally but uses Makaton to communicate. Jackie is concerned that Holly’s fingernails are long and dangerous as she is scratching herself. Jackie decides to cut them as part of what Jackie felt were personal needs although Holly did not seem to want Jackie to do this at first. Jackie’s manager then expresses concern and initiates a disciplinary procedure as she felt Holly’s rights have been violated in that she did not seem to have been given a choice and there was no consultation with others in the team. Jackie has taken the view that she is acting in Holly’s best interest and has a duty of care.

Case Study 2

Ty is a social worker with a heavy caseload of adult clients with diverse support needs and this has been increased due to a colleague’s sickness. Ty tells his manager that he is struggling to divide his time equally and fairly between the clients as he has two cases that are demanding a lot of attention. These two cases are high risk and involve children. His manager says that she is unable to lighten Ty’s caseload. Ty is very distressed as he feels torn between trying to meet all his clients’ needs fairly or by prioritizing the two high-risk cases but in doing so disadvantaging his other clients and letting them down.

Case Study 3

Temi and Phil have been residents in the same care home for a number of years. Both have lost their spouses and, though they feel they could not live anywhere else, are mentally competent. They have recently become very close and seem to have a relationship, although their respective families do not seem to be aware of how intimate they have become. One day when Temi’s son is visiting, he goes into her room to find Temi and Phil in bed with each other. Temi’s son demands that they be ‘kept separate’ as he feels she has been abused or he will move her. Temi has said she feels this is entirely her business to do what she chooses as she has a right to privacy and a relationship and that no one should interfere. The manager reluctantly agrees that she will try to do as Temi’s son wishes.

Case Study 4

Jordan is admitted to the hospital as he has been found to have TB. He is being nursed in isolation and as, a result of investigations, he is found to have contracted syphilis. Jordan is a 33-year-old married man who has recently been involved in casual sex with men. His wife is unaware that he is bisexual and Jordan has made it clear that under no circumstances is his wife to be informed. However, it is likely that his wife is infected so he wants the hospital staff to ask their GP to treat her without giving her a diagnosis. Jordan says he loves his wife and she will be devastated; therefore, it is his wish to do all he can to keep his marriage together. He demands that the medical and nursing staff respect his confidentiality or he will discharge himself. The doctors say Jordan’s wife must be told and that she cannot be treated without giving informed consent.

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