Susan Brown, his usual personal care assistant, has returned from holidays and finds Jun-Wei is still not out of bed. It is now 09h00, this is not normal behaviour for Jun-Wei. Susan notices that he is very wheezy and seems unable to manage his puffer. He says he thinks he has a cold. Susan helps him to get ready for the shower and he manages to wash himself with much more effort than usual. He says he is not hungry and doesn’t want to go out today. He seems sad.
The organisation has procedures that state the following:
• Client personal information is recorded on a personal details form.
• All client information goes into the client’s file that is locked in the filing cabinet in the staff office.
• Client progress notes are to be updated by every staff member at the end of each shift.
• Money spent is to be recorded in the petty cash records in the finance folder in the staff office.
• Changes in clients’ needs or health are to be reported as soon as possible, by phone, to the area manager.
• Incident reports are to be completed if a client is put at risk or puts themselves at risk.