Presentation on theme: "RO21: Essential values of care for use with individuals in care settings 15 th January 2015."— Presentation transcript:
RO21: Essential values of care for use with individuals in care settings 15 th January 2015
What will we learn? LO1: Understand how to support individuals to maintain their rights LO2: Understand the importance of the values of care and how they are applied LO3: Understand how legislation impacts on care settings L04: Understand how personal hygiene, safety and security measures protect individuals
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Key words/Glossary What might you be called if you use a health and social care service? What might you be called if you work for a health and social care service? Service User Patient Resident Care worker Care Practitioner Service Provider
Rights On your tables mind map what rights you think you should have when you are a service user. Rights What are rights? You will be explaining these to the rest of the class.
A real story about a hospital experience……….. Once upon a time, there was a woman called Louise. She decided to book a holiday abroad and take her family. This consisted of her husband, daughter and son. They arrived in Majorca on 24 th March On the first evening they unpacked and went out for a meal. It was a lovely evening. Later on they went to bed. In your books write down any key words that come up during the story
The next day the family woke up early as it was an important day. It was Carl’s birthday. As Louise prepared breakfast for everyone, the hotel manager sent champagne as a birthday present. The children went for a swim. The family decided to go for a walk. They head towards the shops and restaurants. Louise wanted to take Carl out for a meal as it was his birthday. Euan decided that he wanted to buy a football and play with it on the beach. Louise wanted to sunbath. In the end, the family decided to play volleyball on the beach. Carl drew a line in the sand and said “boys versus girls”. They started to play the game. Carl hit the ball over the line to Evie, Evie hit it back to Euan. Louise saw the ball coming towards her and hit it back as she did, she fell over.
As Louise fell, she heard both of her bones break in her left leg. She screamed and screamed. People left the beach. Both children saw what had happened and ran to help their mum. Carl had not seen what had happened and thought it was just a small sprain. This is where the problems started……..
Louise sat on the beach crying. A restaurant owner ran over and gave her a bag of ice to put on her leg to try and reduce the swelling. She sat and waited. She couldn’t stand up and couldn’t raise her leg as it started to swell and swell. What do you think happened next?
If you thought an ambulance should have arrived. You are correct, however, it didn’t. The police arrived. There was a language barrier and as the policeman came over he grabbed Louise’s leg and squeezed it. She screamed. They tried to speak to one another but didn’t understand. The policeman helped Carl carry Louise off of the beach and took her to the local doctors surgery. Do you think this is the right place to go? Was Louise consulted? Why do you think that they took Louise to the doctors? Was she given a choice?
At the doctors surgery, the receptionist refused to fill in any paperwork or make an appointment until Carl fetched the E111 form and insurance paperwork. Louise was left in reception. Carl ran to the hotel and fetched it. Louise was given an injection to help with the pain. They waited for 4 hours until the ambulance eventually arrived. As it was Easter Sunday there was many accidents and they were busy with fatalities. The ambulance driver asked Louise to get up and walk to the ambulance. Louise couldn’t do this. Louise was put in the back of an ambulance, but by this time the pain relief had worn off. Was Louise given all the medication and help she needed?
Louise arrived at the hospital. She was put on a stretcher and left in a corridor with several drunk men who had been in car accidents. Her husband couldn’t stay with her as the children were too young to leave the reception area. Louise waited another 4 hours in a corridor. She was seen by a doctor and taken for an x-ray. Louise met an interpreter who told her that she had broken both bones in her left leg. They decided that she needed to have her bones pulled back into place. This was done by several doctors and nurses. After waiting for 8 hours Louise was taken to the ward. What do you think happens next?
Louise remained in the bed for the next 3 nights and 4 days. She was not given any food at all during this time. This was because they were unsure as to whether she was going to have an operation. Louise was not able to wear her own clothes. Louise was not able to go to the toilet and needed to use a bed pan, however, she was often left for hours and hours. Luckily, she was next to an English speaking patient and had someone to talk to. There were no leaflets or information in English given to Louise. She often asked for help and to speak to the interpreter but no one came. What do you think should have happened? Was Louise given a choice of what to eat, drink or wear?
On the third night, Louise’s family left the hospital after visiting hours. Louise was falling asleep. A nurse came up to the bed and started to drag it away. The nurse stated, “you operation”. Louise grabbed onto the wall as none of her family knew she was having an operation. Louise text her husband. Louise was taken to the preparation area for the operation. She had her clothes taken off her. Again she asked for an interpreter but no one came. An anaesthetist then pushed Louise’s head forward told her not to move and injected her spine, giving her a spinal block. She was then wheeled through into the operating theatre, awake. The operation started, however, the anaesthetic had not taken and Louise could feel the first cut in her leg. She had no idea what they were going to do to her leg. During the operation Louise had no one talking to her and could smell the burning bones and hear all the noise from the drill. The anaesthetists sat at the back of the room reading magazines. After 3 long hours the operation was over, Louise still had no idea as to what had happened. She was in a lot of pain and given paracetamol. This did not take the pain away. Louise called for a nurse, she said “you should respect me if you want more help.” Louise then called for a doctor, he stated, “you should have learnt to speak more Spanish before coming here.” Do you think these comments were appropriate? Do you think the nurses kept the information confidential?
The insurance company then phoned the hospital and wanted to move Louise to a private hospital. Louise could hear the nurses and doctors talking about her, but didn’t know what they were saying. Louise, did not receive any pain relief. A nurse came to Louise and asked her to sign papers, she had only had the operation 8 hours previously, she had been discharged, in Spanish. She was unable to take any paperwork with her to the next hospital and the ambulance drivers came to move her. She couldn’t walk or move as the spinal tap had not worn off. When Louise arrived at the private hospital the doctors and nurses were all ready to operate on her. They had not realised that she had already had the operation the evening before. There had been no communication between the two hospitals. Louise was really scared as she could not communicate with the doctors and nurses. As the doctor had not been informed that Louise had already had the operation, he decided to cut the pot off her leg. This was done without pain relief. Louise was taken for an x-ray to try and establish what had been done during the operation as Louise didn’t know. Louise was taken to a private room, given pain relief, introduced to the interpreter, taken to the toilet and given a healthy meal. What is the difference between both of the hospital treatment received?
In pairs, discuss everything that went wrong with this scenario Title: Louise’s story Bullet point what you think went wrong Then write about what should have happened. Think about what would have happened in this country if Louise hurt herself.
Plenary – Three Things In your books tell me: 3 things you know now that you didn’t an hour ago 3 things you want to know more about
What are my rights? Equal and fair treatment Choice Confidentiality Protection from abuse and harm Consultation
What happens if my rights are ignored? The Staffordshire NHS Scandal. Equal and fair treatment Choice Confidentiality Protection from abuse and harm Consultation =9sot5wzdk_U
Staffordshire Scandal Around the room are several examples of people who were affected by the Staffordshire scandal. In pairs get one of these examples and discuss what happened. Think about whether their rights were met. Summarise what happened in your books.
Peter Burnhill Leukaemia patient Peter Burnhill, 84, was taken to Stafford hospital in 2007 with breathing problems. When he arrived at A&E he was left to wait for six hours on a trolley. His wife Sonia Burnhill said he was left without food and was "practically ignored by nurses" despite having low oxygen levels. After being transferred to an assessment ward Mrs Burnhill said his condition rapidly deteriorated. He died at home less than a week later. She said: "The whole experience stressed him out, and he came out of hospital visibly shaken and much weaker.“
Bella Bailey Bella Bailey, 86, had a hiatus hernia and suffered breathing difficulties. She died in Stafford hospital after spending two months on a ward following a routine operation in September The public inquiry heard she was left without oxygen because of a shortage of nurses to restore the supply and she was also dropped by hospital staff while being transferred back to bed. Following her death, her daughter Julie Bailey set up the Cure the NHS campaign group to highlight failings at the hospital. She said: "I just wanted to stop what was going on in the hospital and after the first meeting, we realised that the problems at the hospital were more than just our own experiences.“ Bella’s daughter Julie starts the cure the NHS campaign.
Joan Giles Joan Giles, 81, was admitted to Stafford Hospital in January 2009 for cancer treatment. Her lymphoma was originally misdiagnosed as kidney stones. Her family maintain that she was not killed by the cancer but by neglect and misdiagnosis during her month at the hospital. They claimed that she would be left without pain relief for as long as two hours and doctors failed to spot bed sores and severe constipation which left her dehydrated. Her son-in-law, Roger Dobbing, said: "Neglect left her so weak that by the time she got to the sixth session of chemotherapy she was not fit to receive treatment."
Arthur Peacham Arthur Peacham, 68, was admitted to Stafford hospital in 2006 with back pain. He was diagnosed with osteoarthritis. He caught the Clostridium difficile bug while in hospital, before being transferred to New Cross hospital in Wolverhampton when a tumour was discovered on his spine. He later died. His wife Gillian Peacham said when Stafford Hospital told her he had caught C. difficile they admitted they had known 11 other people on the ward were already infected but they had no other place to put him. She said: "The wards were filthy and there were never any nurses and he was often lying in his own soiled bed sheets. "They failed in their duty of care. If it had a been a dog being treated in that way the RSPCA would have blown the hospital apart."
Joyce Williams Joyce Williams, 86, went into Stafford Hospital in 2007 with a broken arm and a urine infection. She died from the urine infection, which was not treated. Her family said that during her stay in hospital she fell out of bed and was mis-handled by nursing staff which left her with bruises all over her arms and back. Her daughter, Castelle Davis, said: "They kept telling me she had dementia because she was forgetful and hallucinating. "I was later told by a nurse friend of mine that she had those symptoms because she was so dehydrated. "She went downhill rapidly because she wasn't eating and weight dropped off her, she was just six stone when she died."
Nicola Monte Mother-of-two Nicola Monte had just given birth to her second child when she had to go back to Stafford Hospital with a bowel condition in She spent the next nine months in hospital after picking up three hospital superbugs, C. dificile, E.Coli and MRSA, and was left malnourished. She said sores appeared all over her body, some even a foot wide, but staff did not seem to care. She said: "Ward 11 was chaotic, not very clean, the toilets were often filthy and people's stool samples were left around in cardboard pots, which I think gave rise to cross infection." Mrs Monte had to give up work after suffering long term problems from her condition. "That time in hospital destroyed the person I was," she said.
Joan Morris Joan Morris, 83, was admitted to Stafford Hospital in December 2006 with a chest infection. Her family said that food and water was left on a table instead of being given to her and she did not have a bath or shower throughout the month she was in hospital. Mrs Morris suffered a heart attack and died four weeks after being admitted. Giving evidence at the public inquiry, her daughter Sandra Whitehouse, who had trained to a nurse herself, said that she was "ashamed of the NHS." She said "My mum received just one day of care in four weeks - and that was the day she died. "In this day and age that standard of care was unacceptable, what went on with her shouldn't have happened."
Dorothy Mountford Dorothy Kathleen Mountford died at Stafford Hospital the age of 78 in She had been admitted with shingles. Her family maintain her death was due to a fall she suffered in the hospital less than a week after being admitted, although the trust had no record of such an incident. Her daughter Jenny Goring said: "I believe that the fall left her shaken and damaged her lung, she was never the same again. "I don't want to lose the hospital because it's important for the community but it doesn't seem like they're learning by their mistakes." She added: "Mum's death devastated our family and lessons need to be learned."
Jane Locke Jane Locke, 46, had been to Stafford Hospital several times with stomach problems and was being treated for cancer. She contracted C. difficile, MRSA, and a streptococcal infection, which it is thought was what eventually killed her in July Her mother June Locke felt that Jane, who had learning difficulties, had been neglected by hospital staff. She said: "They left her in sheets that had faeces on and never put the bed rails up to stop her falling out, when we asked them to. "We were so preoccupied with looking after Jane that we never thought to complain, you think you're the only one."
Ellen Linstead Ellen Linstead, 67, caught both Clostridium difficile and MRSA at Stafford Hospital while being treated for bone cancer. Her daughter Deb Hazeldine said the wards were "filthy" and she would often have to wash faeces off her mother's hands. She said: "What I witnessed on the wards I will take to my grave and it spurs me on to make sure it never happens again to anyone else." When Mrs Linstead died in December 2006 her body was so badly infected with C. difficile that she had to be buried in a sealed body bag. Ms Hazeldine wrote to the hospital and then the Healthcare Commission who upheld her complaint in She said: "There needs to be more accountability - there is no openness - we have a fantastic complaints system on paper, but it's selective whether people implement it or not."
George Dalziel George Dalziel died at Stafford Hospital after surgery for bowel cancer. He was 64. The operation was a success, but his epidural was dislodged leaving him without pain relief for days. His wife Christine said he was left in soiled bedclothes for hours and was too scared to ask his nurse for water. She said: "George was a proud man, he was always very clean and to be put in the position he was put in he felt ashamed, disgusted, he was so upset with what was happening to him." While in hospital Mr Dalziel lost three and half stone and Christine said "his bones were sticking out of his back." She said: "When I left him the night he died I was hugging him and I said 'I love you' and he said 'I love you too' and those were the last words we said."
Ronald Millington Retired engineer Ronald Millington, 63, was a regular patient at Stafford Hospital, having CT scans on his chest because of breathing problems. He was misdiagnosed with fibrous scar tissue until on the third scan doctors found that he had lung cancer. His wife Mary believed if they had spotted the cancer sooner, he would have had a better chance for recovery. He died in May She said: "It's just another mistake in a long line of them at Stafford hospital. "I hope the inquiry helps set it right, because too many people now don't want to go there for fear they won't come out again." Information gathered from BBC News 2013.
Rights What rights do service users have? Hint there are 5! Choice Confidentiality Protection Equal and Fair Treatment Consultation
Nursing the Nation In your books note down Examples of good care When patients are given a choice How confidentiality is maintained How patients are given equal and fair treatment How patients are consulted about their treatment How patients are protected against harm and abuse
Choice What should service users be able to choose? In your groups create a role play in a health and social care setting. Think about the choices they could make Think about how they would choose.
Confidentiality Please provide definitions of both confidentiality and disclosure. What information about service users should be kept confidential? How can this be kept confidential?
Exam Question Explain why it is not always possible to maintain confidentiality in care settings. (3 Marks)
Confidentiality Why might it not always be possible to maintain a service user’s confidentiality? Protection of an individual from abuse and harm (eg. child sex abuse) When there is a risk of the person harming themselves (eg suicidal) When there is a risk of the person harming others (eg. mental health) When there is a risk of the person committing a serious crime (eg.drug dealing) Information has to be shared on a need to know basis
Exam Question Explain why it is not always possible to maintain confidentiality in care settings. (3 Marks)
Protection From what? What could cause a service user harm in a care home? What are the 4 types of abuse? What are the signs of abuse? Neglect Physical Emotional Sexual Split your A3 sheet into 4 Discuss what the signs of each type of abuse might be
Abuse active active
Equal and Fair Treatment Define these key terms: Discrimination Prejudice Race Ethnicity Equality For what reasons could people be discriminated against? What discrimination can occur in health and social care settings? How can we ensure these do not happen?
Direct discrimination Overt individuals openly discriminate against others. Occurs when it is obvious by words or actions of an individual that they are deliberately disadvantaging against another person. i.e. Within a care setting giving preferential treatment to some groups or denying treatment to some groups.
Indirect discrimination This is not as obvious (Covert) It is when certain conditions are in place that demonstrates a preference for some people over others. Rules and regulations make it impossible for a person belonging to a specific group fully participate in society. Difficult to prove, because it is not obvious that this is what is happening.
Emily went to the dentist with a painful toothache. The dentist prescribed antibiotics and said that Emily would have to wait for a week before any treatment could be given. Emily is still in pain. Is this discrimination or not?
Ahmed is diabetic and is in hospital being treated for a heart condition. A nurse offered to cut the fingernails of other patients on the ward but refused to cut Ahmed’s nails saying that he would need specialist attention because of his diabetes. Is this discrimination or not?
Ola’s parents cannot afford to buy her a computer with Internet access, yet all her friends at school have good Internet access at home. Is this discrimination or not?
Michael went for a job interview where he explained that his religious views prevented him from working on Sundays. The employer claimed to respect different religious views, but Michael did not get the job. He was told that he was not sufficiently flexible in his attitudes to being available for work. Is this discrimination or not?
Types of discriminatory practices? There are 8 types, what are they? Discriminatory practices.
Types of discriminatory practices? There are 8 types, what are they? There are 8 types, what are they? Discriminatory practices. Covert abuse of power Overt use of power Prejudice Labelling Bullying Abuse Infringement of rights Stereotyping
Bases of discrimination The cause of any discrimination is termed as the basis of discrimination. For example, a person may be discriminated against on the basis of their diversity. The bases of discrimination are: Culture Disability Age Social Class Gender Sexuality Health status Family status Cognitive ability
How can we challenge discrimination? Create a role play in a health and social care setting where someone is discriminated against. Now have someone challenge that discrimination
How can we challenge discrimination? Three categories: Challenge at the time Challenge afterwards through procedures Challenge through long-term proactive campaigns
Consultation What does this mean? How can we do this?
Exam Question Identify two Rights of patients (2 Marks) Describe how these rights could be supported in a health and social care setting. (4 Marks)
Maintaining Rights Must use appropriate terminology There are certain words we need to use when we talk about maintaining rights
Why it is important to maintain individuals rights? to make people feel valued/raise self-esteem to empower to instil confidence and trust to feel safe to equality of access to services/treatments to have your individual needs met
Exam Question Explain why it is important for patients at a hospital that the rights of individuals are maintained (6 Marks)
How can we maintain rights? By providing advocacy Care workers need to ensure that if a person cannot speak for themselves there is someone available to speak on their behalf. Research an advocacy service. Answer the following questions: What are the called? Who do they speak on the behalf of? What do they do?
How can we maintain rights? By using effective communication. What does Jargon mean? What does Patronise mean? Do you think these care workers should use either of these when talking to service users? Why not? In your books write down: Care workers should not be patronising or speak in a patronising tone because…… Care workers should not use jargon because…… What should care workers do if their service user speaks EAL or has a hearing impairment?
How can we maintain rights? By challenging discriminatory behaviour. What is discrimination? So what would discriminatory behaviour be? In groups make a role play where discriminatory behaviour is not challenged Now make a role play where it is What is the difference to the service user? CW’s should not accept any kind of discriminatory behaviour at any time, they should: Have policies and procedure in place – like what? Challenge the behaviour at the time – how? Follow up and challenge through procedure – how? Long term pro-active campaigning – what does this mean?
How can we maintain rights? By providing up-to-date information.
Health Service Profile Service: Name of service: Location: Contact Details: Opening times: Services offered: Any other information:
How can we maintain rights? By providing up-to-date information. CW’s should provide SU’s with information they need in order to make choices about services, for example, opening hours of services available to them, types of care provided, the location of the different services, and alternatives there are available if they want to change their mind.
How can we maintain rights? By providing information about complaints procedures. CW’s should ensure that the SU’s know how to complain so that if they are not happy with any aspect of the service they are receiving they can do something about it. CW’s/managers must also ensure the follow up any complaints made.
Writing your letter of Complaint Paragraph 1 Introduce yourself and tell the manager where you went, when you went and, briefly, what the problems were. Paragraph 2 & Paragraph 3 Write about the problem in more detail. Give evidence and write about how you felt let down in detail. Paragraph 4 Write about how you want the manager to solve the problem (for example, money back, compensation, an assurance that this will not happen to anyone again) Before you write your letter, think about the following: Formal Language - Avoid slang words. Use key words - Make a list of the key words that you need. Make sure that your sentences are linked together. What linking words or CONNECTIVES could you use? Make sure that you have evidence to support your opinions. Tone of the letter. Be polite and firm. Do not be aggressive.
Exam question Describe two ways effective communication could be used by staff at Woodbridge to support the rights of residents. (4)
Understand how legislation impacts on care settings. Exam Preparation
Look at the pictures on the following slide. In you groups write down a sentence about how the individuals are feeling. StarterStarter
Share your thoughts
Learning Objectives Define the following key terms – law, legalisation, gender and discrimination. Be aware of key laws that promote anti discrimination and equality.
Key Terms – Task 1 In your groups find a definition for the following terms Law Legislations Gender Discrimination
The Laws Equality Act 2010 Sex Discrimination Act Disability Discrimination Act The Children’s Act 1989/2004 Race Relations Act Mental Health Act 2007 Health and Safety at Work Act Data Protection Act
Copy this table into your book… ActWho does this protect? Equality Act 2010 Sex Discrimination Act Disability Discrimination Act The Children’s Act 1989/2004 Health and Safety at Work Act Data Protection Act Race Relations Act Mental Health Act 2007 Complete the table by inserting a list of the groups of people who are protected by this act. Children and young people, Older Adults, People with disabilities, Men, Women, Vulnerable adults, Ethnic minority groups, Everyone
Exam Question Legislation is relevant to different groups of people. An example is given in the table. Complete the table below to identify three other groups of people. (3 Marks) Example: Older Adults 1 2 3
The Laws Equality Act 2010 Sex Discrimination Act Disability Discrimination Act The Children’s Act 1989/2004 Race Relations Act Mental Health Act 2007 Health and Safety at Work Act Data Protection Act You are going to create a booklet on legislation to use for revision. Each piece of legislation needs a page that says -Who it protects? -Key Features of the act You are going to create a booklet on legislation to use for revision. Each piece of legislation needs a page that says -Who it protects? -Key Features of the act
Exam Question Identify one key feature of each piece of legislation. (3 Marks) Children Act Equality Act Mental Health Act
Mark Scheme One mark for each correct feature identified. Three required. Children Act 2004 aim is to protect children (who are at risk) the paramouncy principle-children’s needs comes first children have the right to be heard children’s wishes have to be taken into consideration support must be provided to keep families together where this is possible.
Mark Scheme Equality Act 2010 prohibits discrimination in education, employment, access to goods and services, management of premises, housing covers direct and indirect discrimination covers victimisation/harassment changed the definition of gender re-assignment covers discrimination on the basis of a protected characteristic. perception/association/third party is now an offence women have the right to breastfeed in public places pay secrecy clauses have been made illegal
Mark Scheme Mental Health Act 2007 compulsory admissions for people who are thought to be a danger to themselves or to others sets out processes and safeguards for patients with a mental disorder (sectioning procedures) professional roles – broadens the group of practitioners nearest relative – patients right to have their nearest relative to represent them supervised community treatment (SCT)/aftercare electro convulsive therapy (ECT) – new safeguards for patients provides a duty to provide advocates age appropriate services.
Exam Question Choose either the Equality Act 2010 or Mental Health Act Describe key aspects of the legislation you have chosen. (6 Marks)
The impact of legislation Legislation has impacted health and social care in a number of ways. Match the impact with who it has impacted People who use the services It has forced policies and procedures to be put in place. (e.g. health and safety policy) Care PractitionersCan exercise their rights Service ProvidersIt has raised standards of training and therefore improved the quality of care people are giving.
What are the values of care/care values? There are three P________ _______ and _________ M__________ ______________ P_________ ___________ ______ and _______ Promoting equality and diversity Maintaining confidentiality Promoting individuals rights and beliefs
Values of care What do all of these things mean? Rights Beliefs Equality Diversity Confidentiality
How can each of these care values be applied? Care value corners
Create a poster to show what one care value means and how it can be applied
Describe how each of the values of care could be applied (6)
Early years Care values What is meant by early years? Why might there need to be more care values for younger people? Worksheet
Where are the values of care applied? Draw this table into your books and fill in relevant settings: Health care settingsSocial Care SettingsEarly years and education settings
Why is it important to apply values of care? It is important to apply the values of care in order to _____________________________ which means that all patients would receive the appropriate care and attention no matter what setting they were in. It is also important to ___________________________ so that all service users feel safe. Another reason is to ___________________________ this means that people are aware of what rules they have to follow and the service can progress. Finally it is important to _____________________ so that service users are getting the very best treatment and will feel as comfortable as possible wherever this is occurring. Provide clear guidelines to inform and improve practice Improve the quality of care Ensure standardisation of care Maintain or improve quality of life
The effects on people who use services if the values of care are not applied
Pain Injury Abuse Loss of focus Loss of concentration Lack of knowledge Lack of stimulation Lack of progression Humiliation Anger Stress Low Self-esteem Feeling inadequate Loss of trust Frustration Exclusion Marginalised Poor social skills Anti-social behaviour
Exam Question Analyse the possible effects on a child if the values of care are not applied (8 Marks)
Complete this table
Draw up this table: Security MeasureHow could this measure protect residents? Checking external entrances Monitoring of keys Security pads on doors/locks on doors Window locks Reporting of concerns to line managers Identifying staff CCTV Alarmed doors
Woodbridge is a residential care home for older adults. Some of the residents have dementia. Recently one of the residents with dementia was found confused and alone in a nearby park. The staff at Woodbridge to balance the rights of all residents with the need for safety. Identify two security measures that could be put in place at Woodbridge (2)