Unit 05

Promote equality and inclusion in care settings

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Unit purpose and aims

This unit introduces the concept of equality and inclusion which is fundamental to working in

adult care settings.

The learner will:

1. Understand the importance of diversity, equality and inclusion

2. Be able to work in an inclusive way

3. Be able to promote diversity, equality and inclusion

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1.1 Defining diversity, equality, inclusion and discrimination

In this unit, we look at some of the key definitions and concepts associated with equality

and diversity. The unit then looks at the forces that work against equality, diversity, inclusion

and discrimination.

Defining diversity

Diversity means varied and different. So, when we talk about diversity in the place of work

or community, we are looking at how people differ from each other. We know that everyone

is an individual. But what makes us all unique? Some factors are obvious:

The way we look

The way we choose to dress

The way we behave

Where we choose to live

The type of work we choose to do

The values we choose to live our lives by.

All of these things make up who we are and affect how we lead our lives. When looking at

diversity, there are four main factors that are used to categorise the population:

Age - the number of years that a person haslived

Gender - whether a person is male or female

Class - the socio-economic background that a person is from

Ethnicity - a person’s race or ethnic background.

Remember - ‘different is different’ not ‘different is wrong’

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Defining equality

Equality means 'having the same importance and deserving the same treatment'. It does

not mean treating everybody the same, but it does mean giving everyone the same

opportunities and the same level of respect.

According to the World Health Organisation Equality ‘is the absence of avoidable or

remediable differences among groups of people, whether those groups are defined socially,

economically, demographically, or geographically’ WHO - www.who.int

Equal opportunity means freedom from discrimination in areas such as education,

employment, housing, and healthcare. Discrimination means treating people differently

based on reasons, such as their gender, where they live, race, age, religion or sexual

orientation, rather than judging people on their merits. The Oxford Dictionaries definition is

‘The unjust or prejudicial treatment of different categories of people, especially on the

grounds of race, age, or sex’

http://www.oxforddictionaries.com/definition/english/discrimination

Equal opportunity means freedom from discrimination in areas such as education,

employment, housing, and healthcare.

It is unlawful for employers to discriminate against employees or potential employees on the

grounds of gender, race, marital status, disability, age or sexual orientation when deciding

who to recruit or promote, rate of pay, training offered, or in the way they are treated in the

workplace.

They also have a duty to make reasonable adjustments to meet the needs of a disabled

employee/potential employee.

Anyone providing services to the public or a section of the public and those who exercise a

public function (a local authority for example), are under a duty not to discriminate and, in

the case of a disabled person, have a duty to make reasonable adjustments for the

person’s access to the services.

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Defining inclusion

Inclusion is defined as ‘accepting people’s diversity without discrimination in order that they

can participate in equal tasks’

Defining discrimination

To discriminate or oppress is to treat people unfairly because of who they are, or because

they belong to a certain group of people. Whatever the reason, the intention is to make

people feel bad about themselves, so the effect is always negative. Anyone may be

discriminated against, but certain groups are more likely to be subject to negative

discrimination.

Racial discrimination - implies that there is a normal way to be, promoting a fear of

differences. This can lead to misunderstandings which can develop into hatred

Sex discrimination - suggests that one sex is better than the other and divides the sexes

Disability discrimination - oppresses people with disabilities and suggests that they are

less important

People can also be discriminated against on the grounds of their sexuality or their religious

beliefs.

How direct and indirect discrimination may occur in the work setting

Direct discrimination

Direct discrimination occurs when one person is treated less favourably than another in the

same or comparable circumstances. As well as words or acts of refusal, direct

discrimination includes words or acts of discouragement. Examples may include:

Sheila is refused a promotion on the grounds that her employer is worried she may

become pregnant, thus costing them more in maternity leave, than Bill her co-worker

- even though they are equally qualified. This would be directly discriminating against

Sheila

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An employee is not considered for promotion because of their age

A job is refused to another person because of their disability

An individual with dementia is prevented from participating in activities in a care

home because care workers believe the person will disrupt thesession

Indirect discrimination

Indirect discrimination occurs when a rule, condition or practice is applied that cannot be

met equally by everyone. There does not need to be any intention to do this by the

employer or service provider. The fact that the condition or requirement is in place is

enough to prove indirect discrimination. To succeed in a claim, the claimants need to show

they are members of the protected group and that rules, conditions or practice will put them

at a disadvantage.

This could include:

Refusing to allow employees to work flexi-time where there is no business

requirement preventing this. This indirectly affects more women than men because

they are often the principal carers of young children

Insisting that all employees work on Saturdays. This indirectly affects those of the

Jewish faith because Saturday is their holyday.

There may be situations where an employer or service provider can justify the provision,

criterion or practice. To do this, they must show that the requirement is a proportionate

means of achieving another aim which is not discriminatory. For example:

Refusing to allow employees Saturdays off may indirectly discriminate against

people of the Jewish faith, but if the employees were employed as stewards at a

football stadium this can be justified, as most football matches are held on

Saturdays.

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Direct and indirect discrimination in care settings

Discrimination can occur for a number of reasons and in a variety of ways including:

Misunderstandings about the culture and beliefs of others can lead to attitude

problems and care needs not being fully met

Access to training and learning experience may be restricted, especially if there is a

language barrier and no provision to overcome this

Individuals may have their rights withheld, particularly their right to choose

Opportunities to access and use resources and facilities may be limited

Employment of care workers who are in any of the groups mentioned may be

affected. Care workers may be discriminated against by colleagues and those they

care for, creating tension which could lead to conflict or bullying.

Stereotyping - the meaning and effect

This is the process of making assumptions about an individual based on the group which

we feel they belong to. The way in which we view certain sections of the population leads to

stereotyping. We may draw conclusions about their behaviour, diet, beliefs, dress or even

intelligence, based on unreasoned opinions.

Labelling - the meaning and effect

Labelling is to describe a person by the use of a ‘label’ or word which creates a certain

image and can give a negative impression of that person. The image the person has of

themselves can be affected, and confidence and self-esteem can be lost. Individuals who

are labelled may have their rights withheld and the quality of the care they receive may

suffer. We may spend less time with individuals who we feel uncomfortable with, or are

even fearful of, because of the image we feel they project.

In a care setting this may affect:

The way in which we relate to people

How we communicate with them

The quality of care they receive.

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Therefore, the way we speak about people and the opinions we form can directly affect their

experiences of the care sector.

Positive Discrimination

You may have heard the term ‘positive discrimination’. This is different to discrimination

which oppresses people and leads to unfair treatment. The purpose of positive

discrimination is to allow people who are disadvantaged or are traditionally discriminated

against, to access opportunities and to have equality with those less disadvantaged. For

example, an educational institution such as a university may set admission targets for

entrance from state schools, ethnic minorities and those with disabilities. The long-term goal

being more access to higher education and an increase in life opportunities for under-

represented groups.

1.2 Potential effects of discrimination

Potential effects of discrimination can include things like disempowerment as the person

may feel that they no longer have control of their own life, resulting in low self-esteem and

self-identity.

Some people may try to fight against the discrimination causing an argument, but many

people do not and they lose their confidence. As a result of discrimination, they may then

become depressed and feel devalued as well as disempowered. This could lead to health

issues and to them becoming withdrawn and isolated from society. Low self-esteem can

lead to people losing their self-worth. The effects could also lead to a feeling of

worthlessness and depression. They may become withdrawn and isolate themselves in

their home, making them feel they are alone and that no one is there for them. All types of

discrimination can lead to restricted opportunities and access to health and social care

provision.

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1.3 How inclusive practice promotes equality and supports diversity

Differences between racial groups should be celebrated. Each culture brings with it different

skills and different ways of looking at, and solving, problems. All individuals should be

included in the planning and delivery of all aspects of their care. This will ensure that the

service provided does not discriminate and puts the individual at the centre of everything

you do. Decisions are made, and care is delivered with the individual’s knowledge,

understanding, co-operation and consent.

You, as a care worker, should actively support individuals to participate as much as they

are able to promote a sense of value and worth.

It is often perceived that disabled means less able to do a particular job. But this simply isn’t

true. Often, people with a disability have productivity levels equal to those of people without

a disability.

Different people have differing views on different sexual orientations. It’s fine that your

beliefs won’t always be the same as other peoples. After all, you would not necessarily

expect to have the same views on religion or politics as the person sitting next to you. What

is important to understand is that whether or not a person’s relationship choices are the

same as your relationship choices, it is their right to receive levels of care and care services

equally and inclusively.

For many people, their knowledge of increasing diversity comes mainly from the media and

that immigration into this country is increasing. But it is important that we all understand the

changes that are happening to the population of this country because whilst urban areas

may be mostly affected by an increasingly diverse population, this will gradually expand to

other areas.

Therefore, we will all have to embrace diversity and the benefits that it brings.

Valuing diversity brings benefits to people at work, in education and the community as a

whole. Valuing diversity requires respecting beliefs, values, religious practices, food, dress

and social etiquette of other people not behaving in ways which cause needless offence,

and not misrepresenting or disparaging other people's beliefs and practices.

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2.1 How legislation, policy and codes of practice relating to equality,

diversity and discrimination apply to own work role

Legislation and codes of practice

All laws are designed to act as a deterrent, preventing people from causing harm. As the

world changes and develops, old laws are updated, and new laws are made to meet the

changing times. Legislation also indicates best practice and sets out what is expected. In

this way, laws direct the behaviour of adults.

As the UK is a member of the EU, it has to abide by European laws as well as those

introduced within the UK. This may change following ‘Brexit’. The United Nations also has

an influence and effect on UK law.

Alongside laws, the government also produces documents in the form of guidelines. Some

of these advise on best practice and detail what should be done, but don’t lead directly to

legislation. Others set out proposed legislation on its way through the Parliamentary

process which states what will have to be done, by law. These are referred to as Green

papers, White papers, Bills or Charters.

Government policies change over time as do workplace policies. Care workers need to be

aware of their workplace policies, including those related to equality, diversity and

discrimination.

Workplace policies on this should reflect current legislation, particularly the Equality Act

2010.

Legislation and Codes of Practice relating to Equality, diversity and discrimination

The main piece of legislation is - The Equality Act 2010

The Equality Act is in place to protect people from discrimination this could be in schools,

the workplace, health or social care settings and extends to the wider society - protecting us

all.

You are considered disabled under this act if you have a physical or mental impairment that

has ‘substantial’ and ‘long-term’ negative effects on your ability to do normal daily activities.

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This Act replaced previous legislation such as the Race Relations Act 1976 and the

Discrimination Act 1995 and brought together over 116 separate pieces of legislation into

one single Act. The main reason for bringing the legislation together was to simplify,

strengthen and harmonise previous legislation.

https://www.equalityhumanrights.com/en/advice-and-guidance/equality-act-codes-practice

Further information about these and other Acts can be found by searching - www.gov.ukand

to find those acts/part acts repealed by The Equality Act look at –

http://www.legislation.gov.uk/ukpga/2010/15/schedule/27

When a healthcare organisation provides goods, facilities or services to the public, it must

make sure that it does wheat equality law says it must do, this is irrespective of where the

service is provided.

Equality law affects everyone responsible for operating an organisation or providing a

service on behalf of an organisation and includes both staff and volunteers.

All public services and those who carry out public functions on their behalf (this includes

health and social care sectors) must have a ‘due regard’ the need to eliminate those types

of behaviours/attitudes prohibited under The Equality Act 2010. The Human rights Act 1998

and The Mental Capacity Act are also relevant here. Further information can be found on

the following site www.equalityhumanrights.com

The Equality laws acknowledge that there will often be a need to change the ways services

are offered or provide extra equipment to meet the needs of those individuals with a

disability this relates to the duty to make reasonable adjustments to remove barriers for

disabled people.

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If you work in Education, Recruitments, Employment you could look at the specific

legislation your organisation may have to adhere to such as Special Educational Needs or

Equal Pay.

Sources of information, advice and support about diversity, equality and inclusion

Public sector

organisations

Charitable and voluntary

organisations

Self-help groups

Local councils or

authorities; Libraries;

Direct Gov

Citizens Advice Bureau Alcoholic awareness

Community Bodies/Groups Victim Support Groups Drug problem Groups

Hospitals; GP surgeries Mencap; MIND Parenting Groups

Job Centre Plus Royal National Institute for

the Deaf; Action on Hearing

loss

Single Parent Groups

Royal National Institute for

the Blind

Sexuality Groups

How to access information, advice and support about diversity, equality and

inclusion

There are a number of ways in which you could access the information advice and support

you might need including:

Consulting your organisation’s policies and procedures

Approaching your supervisor or manager

Attending training

Searching the internet or read books

Contacting the Human Rights Commission.

In larger organisations, if the matter were concerning your employment, you may be able to

contact the Human Resources Department for advice and guidance

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When to access information, advice and support about diversity, equality and

inclusion

You could access information, advice and support about diversity, equality and inclusion for

a number of reasons, the following are examples and the list is not exhaustive:

For general information if you are doing some research, training, or have an interest

When you have difficulty supporting an individual’s rights

If you are concerned about others who are intolerant, discriminatory, stereotyping,

harassing or bullying others

If you are treated unfairly in the workplace

If you are discriminated against for being associated with another person who has a

protected characteristic

If your housing association discriminate against you

If you are discriminated against in education, health or social care services.

2.2 How to work with individuals respecting their beliefs, culture, values

and preferences

An individual needs to talk, to be listened to, and to be involved with others. You should

consider what the best way is to communicate with each person you support in order to

interact in an inclusive way. As a care worker, you must accept the diversity of individuals

and not discriminate. All individuals have the right to be included, not only in their care, but

also in social activities and family life - and be able to access and use the services and

resources of the community and the health care system. You must ensure that you inform

and include the individual in all aspects of the assessment, planning, implementation and

evaluation of their care. You must also encourage participation in family, social and

community life, and any activities organised by the care setting.

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3.1 Actions that model inclusive practice

Inclusion and occupation - doing something meaningful

All of us need to feel actively occupied and included in the life we are part of. This means

knowing the difference between doing an activity compared to being involved and included

in something that is meaningful to you as an individual.

Expressing needs and feelings

Every individual should feel that they have a right to express their feelings and

communicate their needs. As a care worker, you must respond to this in a way that shows

you support their rights to this expression. It can be very easy for care workers to take

individuals’ comments personally, feeling they are being criticised instead of viewing

comments as helpful and constructive.

Enabling inclusion

There may, however, be individuals who are unable to understand or fully participate. It is

both your responsibility and that of other health care professionals to ensure that all

individuals are interacted with, in an inclusive way. Any barriers to communication and

inclusion should be identified and addressed by adapting communication to ensure

interactions are inclusive.

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Interactions may need to be supported by aids and equipment, other health care

professionals, (e.g. speech and language therapists), social workers, signers for British

Sign Language, interpreters or advocates.

It is important for care workers to involve the individual in all aspects of their daily life. By

having an understanding of the individual’s wishes, needs, views, beliefs and culture shows

you are taking a genuine interest and showing a respectful approach to their care.

Inclusive practice

‘Variety, differences’

It is essential that care workers behave in a way which clearly demonstrates they accept the

diversity of people and are not passing judgement. People have a right to express and

communicate their beliefs and views. We are all diverse individuals with differing

personalities, skills, interests and talents, and the benefits of this diversity to individuals and

society as a whole, must be acknowledged.

Support for culture, beliefs and values

Individuals have a right to receive care and support that allows cultural expression. It is

important to empower them to do this as it strengthens all aspects of their needs and

development.

Maintaining contact with others who have the same beliefs and traditions provides social

opportunities, a sense of belonging and keeps them mentally stimulated.

Aspects of culture can include diet, activities, personal care beliefs and preferences,

communication, care practice that impacts on a daily basis - e.g. choice of gender of care

worker - actions in times of illness, dying and death. If there is no support for individuals to

satisfy cultural beliefs and values, then there would be no supportive relationships. Values

and beliefs are developed through life and can vary depending on family traditions,

background, experiences, growth and development. These are the important issues in our

lives that influence the way we behave and relate to people and situations.

Professional and organisational values are the foundation of all care practice. Similarly, an

individual’s values and beliefs are what they base their lives on. You may have experienced

individuals who consider that their beliefs and values are the only ones that matter, and can

be dismissive of others’ values because they are different.

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The necessary support can be given, providing you are familiar with the preferences of the

individual. It is important to know the history of a person as this can help explain their

present behaviour and attitudes.

Talking with and listening to them, showing respect for their views and demonstrating active

listening skills will convey support. These actions empower the individual to be more

confident and boost self-worth and self-esteem. This, in turn, further consolidates the

professional relationship.

There can be wide cultural differences within areas of the United Kingdom, so awareness

must not be solely focused on individuals with origins in another country or different religion.

Regional differences can be quite marked and specific within our country; these can relate

to expectations, family involvement, aspects of language and customs.

Person-centred care

Person-centred care is an approach that puts the individual at the centre of everything you

do. Therefore, all care revolves around, involves and includes the individual in order to fully

meet their needs, wishes and preferences.

Holistic care

It is important that the whole care needs of the individual are met. Care should be planned

to take into consideration the spiritual, psychological, social and physical needs. This

means looking at the individual as a whole person, rather than just focusing on the medical

condition. In order to provide holistic care and ensure inclusion, it is important that care

workers find out about the individual’s needs wishes and preferences.

Encouraging individuals’ views to be expressed and listened to

It is essential to understand how individuals feel in a care setting. There should be systems

in place to allow individuals to give feedback, both positive and negative. Care settings

should have regular meetings with individuals, their families and advocates to ensure they

are happy and to ask for their suggestions.

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Suggestions may or may not be easy to implement, but will always be an insight into the

needs, wishes and preferences of individuals. Actions to implement agreed changes should

be seen to be taking place, and individuals kept informed. Changes may make a significant

difference to individuals’ lives, promote feelings of self-worth, and enhance relationships

with care workers and other health professionals.

Empowerment “Authorise - Enable”

Individuals will feel in control of their lives. Assuring that they are aware of their rights and

choices, and that these are actively promoted, will help them to be confident and develop a

feeling of self-worth. Individuals will be encouraged to say what they want, express opinions

and make suggestions about the care they receive. This should apply to all individuals.

Provision should be made to allow those who have difficulty expressing their needs and

wishes to make suggestions, comments and complaints, in order to prevent discrimination

and promote equality and inclusion.

3.2 How to support others to promote equality and rights

Supporting others

Support for cultural beliefs can be achieved by working as part of a team with colleagues,

passing on relevant information and by ensuring less experienced staff are aware of factors

that influence values and beliefs systems. These relate to diet, customs, personal care,

religious practice, dress and socialising. It can create difficulties if you are supporting a

person who has strong negative views on race, religion or behaviour. They are entitled to

their opinions. However, other people are also entitled to their beliefs and to live their lives

accordingly, without the distress of negative reaction from others. Alongside these rights go

corresponding responsibilities. When enjoying the right to uphold values and beliefs, people

have a responsibility to ensure others can enjoy their rights and not be discriminated

against.

You can also support others to promote equality and rights by being a positive role model

yourself. Be aware of the policies and procedures of the setting, attend training and passing

knowledge to colleagues which will also help them to be aware of equality and rights.

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3.3 How to challenge discrimination in a way that promotes change

Discrimination can come from many sources, including yourself, other colleagues, other

service users, in communications or in the media. Discrimination is unlawful and people are

protected from discrimination under The Equality Act (2010). Your organisation will have

policies on discrimination, which will include how it should be reported and dealt with. It is

important that you follow these policies and procedures in a way that recognises and

challenges acts of discrimination and encourages change. It is important that acts of

discrimination are reported immediately in order to protect the rights of the individual.

Changes to attitudes and working practices may be required in order to bring about change

and end discriminatory practices; this could include providing training courses, focus

groups, reflective activities and team building exercises. It is important to help other people

understand why changes are needed and being introduced. Understanding aids acceptance

of change in working practices. Enforced change or changes that are not fully understood

will not be successful.

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Conclusion

The information you have read within this unit should increase your knowledge and

understanding which will benefit you, the individuals you care for, key people and others.

Now complete the assessment questions for this unit in the workbook section.