Benjamin has a lifelong history of asthma and now, aged 65, he has other severe lung problems exacerbated by gaining a lot of weight in middle age. He worked in a local supermarket but two years ago, Benjamin suffered a stroke leaving a residual dense paralysis of the left side of his body. After a long period in hospital, he moved into a nursing home where he has been living for over a year. Benjamin has been married to Jan for 40 years and she visits daily – they have no other immediate family.  He is not able to care for himself and it takes at least two people to move Benjamin in and out of bed, shower and dress him, and settle him into his wheelchair each day, before his wife comes to visit him just before lunch. Recently, the care home has had several periods of severe staff shortages and his wife has been coming earlier in the day and helping the care assistants move him, though this is against home policy. The managers and team leaders are not seemingly aware of Benjamin’s wife being involved in his personal care, which involves moving and handling. Jan has been asking the care workers about his going home as she is feels Benjamin is depressed – he has frequent mood swings between being tearful, angry and withdrawn and that she could manage him. However, the social worker assigned to their case, Dave, has said Benjamin is not able to go home yet as his wife could not cope with him on her own.  The social worker assigned to Benjamin’s case, Dave, feels that their house is quite old and would need some major alterations as Benjamin would not be able to manage the stairs. He has suggested that a full home assessment might be a good idea but the GP, Leanne, who visits the home is not keen on discharge saying Benjamin is still too overweight and that this is putting him at extra risk of further health problems as well as making it difficult to help him in and out of bed. Benjamin is dismissive and angry with the care staff when they suggest he needs to eat more appropriately as the GP has advised.

Questions

What are the potential problems of working in a way which is not consistent with care home policy?  Whose responsibility is it to ensure the care team function safely?

What actions should be taken by the home manager to ensure they are aware of Benjamin`s needs?

What other members of the health care team should be involved to help Benjamin to eat a diet which could help his weight loss?

What might be done to improve Benjamin`s mobility?

Who should undertake Benjamin`s home assessment?

How could the members of the multi-disciplinary team work effectively to help Benjamin in respecting his autonomy with regards to his return home?
800 words please help