Everything we do in social care relies on someone, usually the service user, providing their consent.  Looking at various forums and having discussed this issue with many nursing and care staff over the years, it is however apparent that many people working in social care don’t really understand consent.  After my previous blog about the fundamental standard of consent I was questioned about my assertion that consent was a process and not a one-off event, this blog is in response to that question.

Some care staff think consent is a one of event undertaken by the manager when a person is admitted to the service, this could not be further from the truth.  That said, the way consent is treated by regulators could quite easily give this impression, when inspectors tend to look for written consent in care plans rather than asking service users whether staff ask their permission to do things each time they approach them.

“What’s that?” I hear you ask.  “Ask for consent every time I approach a service user?”.  Well yes.

Consider this simple scenario.  When you approach Joan in the morning do you say “it’s time to get up Joan” or do you say ” would you like to get up now Joan”.  The first is a command, the second a question which implies consent is needed.

Why is this important?  Well, asking, rather than telling service users:

– Demonstrates respect for them as humans. – Suggests you care about person-centered, rather than task orientated care. – Is the right thing to do. – Creates the culture of care within the team

Let’s face it, do you like other people deciding things for you and more to the point, do you like people deciding things for you all of the time?

Consent is not a one off event.  Just because Joan has signed a form to say she is happy for the delivery of personal care while in your care, does not mean that this happens on your terms, when you want to deliver the care and how you want to deliver the care.

Some of you will now be thinking, but what if Joan does not have capacity?  There is nothing in the Mental capacity Act that suggests that someone lacking capacity should not be asked for consent, in fact quite the opposite.  The MCA suggests that even people without apparent capacity can make some decisions for themselves.  And as a carer you should also ask the question “just because Joan does not have capacity in all things do I no longer respect her as a human? Should her care not be person-centred?  Is asking her not the right thing to do? Is this the sort of culture in which I want to work?”.

I would suggest that any carer who thinks the answer to any of these is yes, needs to consider what they are doing working in a caring profession.

Consent is therefore not a one-off event.  Consent in social care, as in life, is a process and as such is ongoing and needs to be sought every time care is delivered.  Not only does this make a care setting a better place to be, it creates culture of care which are obviously caring and responsive.