Supporting core practice in Health and Social Care (Adults) Cefnogi ymarfer craidd mewn Iechyd a Gofal Cymdeithasol (Oedolion)
Positive approaches to reduce restrictive practices in health and social care Dulliau cadarnhaol o leihau arferion cyfyngol mewn iechyd a gofal cymdeithasol

Positive approaches are based upon the principles of person centred care:

• getting to know an individual
• respecting and valuing their histories and backgrounds and understanding:
  • their likes and dislikes
  • their skills and abilities
  • their preferred communication style and support structures.
• understanding the impact of their environment upon them and using this to identify ways to support individuals consistently in every aspect of the care they receive

Positive approaches involve working with an individual and their support systems to:

• try to understand what they are feeling and why they are responding in the way they are
• where possible, undertake any required changes and intervene at an early stage to try and prevent difficult situations at all
• understand what needs to be planned and put into place in order to support the individual to manage distressed and angry feelings in a way that reduces the need for behaviour that challenges any restrictions.

Mae dulliau gweithredu cadarnhaol yn seiliedig ar egwyddorion gofal person-ganolog:

• dod i adnabod unigolyn
• parchu a gwerthfawrogi ei hanes a'i gefndir a'i ddealltwriaeth:
  • ei hoff bethau a'i gas bethau
  • ei sgiliau a'i allu
  • yr hyn sy'n well ganddo o ran dull cyfathrebu a strwythurau cymorth.
• deall effaith ei amgylchedd arno a defnyddio hyn i nodi ffyrdd o gynorthwyo unigolion yn gyson ym mhob agwedd ar y gofal maent yn ei gael.

Mae dulliau gweithredu cadarnhaol yn cynnwys gweithio gydag unigolyn a'i systemau cymorth er mwyn:

• ceisio deall beth mae rhywun yn ei deimlo a pham ei fod yn ymateb fel y mae
• lle bo modd, gwneud unrhyw newidiadau sydd eu hangen ac ymyrryd ar gam cynnar er mwyn ceisio atal sefyllfaoedd anodd yn y lle cyntaf
• deall beth sydd angen ei gynllunio a'i gyflwyno er mwyn cynorthwyo'r unigolyn i reoli gofid a dicter mewn ffordd sy'n lleihau'r angen i ymddwyn mewn ffordd sy'n herio unrhyw gyfyngiadau.

Restrictive practices are a wide range of activities that restrict an individual’s ability to do what they want to do without some form of intervention or encourages them to do things that they don’t want to do. They can be very obvious or very subtle. They should be understood as part of continuum, from limiting choice, to reactive response to an incident or an emergency or if an individual is going to seriously harm themselves or others.

Mae arferion cyfyngol yn ystod eang o weithgareddau sy'n cyfyngu ar allu unigolyn i wneud yr hyn y mae am ei wneud heb ryw fath o ymyriad neu sy'n eu hannog i wneud pethau nad ydynt am eu gwneud. Gallant fod yn amlwg iawn neu'r mymryn lleiaf. Dylid eu deall fel rhan o gontinwwm, o gyfyngu ar ddewis, i ymateb adweithiol i ddigwyddiad neu argyfwng, neu os yw unigolyn yn mynd i niweidio ei hun neu eraill yn ddifrifol.

When working with an individual with a particular syndrome, disability or condition, it is important to have a full understanding of the possible effect on behaviour. For example, a person with autism and a learning disability may present behaviour that their family members and support workers find difficult to understand and that they believe to be challenging.

A greater understanding of the individual will enable workers to be better equipped to know what to do and how to prevent specific responses on other occasions.

It is easier to understand an individual’s behaviour if workers have a better understanding of their experiences, this may include considering how having a particular syndrome, disability or condition has affected their communication, social interactions and sensory awareness. What happens in the environment around the individual is often under the control of the individuals supporting them. For example, if an individual finds being with many other individuals in a small room difficult, then the impact of this can be reduced simply by ensuring that the individual does not spend time in confined spaces with lots of individuals.

Communication breakdown may contribute to challenging behaviour, so it is important to understand individual’s approach to communication and work to better understand what they are trying to say or indicate.

Wrth weithio gydag unigolyn sydd â syndrom, anabledd neu gyflwr penodol, mae'n bwysig deall effaith hynny ar ei ymddygiad yn llawn. Er enghraifft, gall unigolyn ag awtistiaeth ac anabledd dysgu ymddwyn mewn ffordd y mae aelodau o'i deulu a gweithwyr cymorth yn ei chael hi'n anodd ei deall ac sy'n heriol yn eu barn nhw.

Bydd dealltwriaeth well o'r unigolyn yn galluogi gweithwyr i fod mewn sefyllfa well i wybod beth i'w wneud a sut i atal ymatebion penodol ar achlysuron eraill.

Mae'n haws deall ymddygiad unigolyn os oes gan weithwyr ddealltwriaeth well o'i brofiadau. Gall hyn gynnwys ystyried y ffordd mae syndrom, anabledd neu gyflwr penodol wedi effeithio ar ei allu i gyfathrebu, ei ryngweithio cymdeithasol a'i ymwybyddiaeth synhwyraidd. Yn aml, mae'r hyn sy'n digwydd yn yr amgylchedd o gwmpas yr unigolyn o dan reolaeth yr unigolion sy'n ei gefnogi. Er enghraifft, os bydd unigolyn yn ei chael hi'n anodd bod gyda llawer o unigolion eraill mewn ystafell fach, yna gellir lleihau effaith hyn drwy sicrhau nad yw'r unigolyn yn treulio amser mewn lleoedd cyfyng gyda llawer o unigolion.

Gall problemau cyfathrebu gyfrannu at ymddygiad heriol, felly mae'n bwysig deall y ffordd mae'r unigolyn yn cyfathrebu a gweithio i ddeall yr hyn y mae'n ceisio ei ddweud neu ei fynegi yn well.