2022 CCEA AS-Level Health and Social Care 0003 Practice Paper with Answers

Empowerment means enabling and supporting a service user to have control over their own life [1], and to make their own decisions about the care and support they receive, rather than decisions being made for them [1].
Final answer: empowerment = enabling a service user to have control over, and make their own decisions about, their own life and care.

[2] 1 mark: reference to enabling/giving the service user control over their own life; 1 mark: reference to the service user making their own decisions/choices about their care, rather than having decisions made for them.

Person-centred care is an approach to care that focuses on the individual service user's own needs, wishes and preferences [1], involving them as fully as possible in decisions about their own care [1]. In practice, this could be shown, for example, by asking a service user what time they would like to get up or what they would like to eat, rather than requiring them to follow a fixed institutional routine [1].
Final answer: person-centred care = care focused on and shaped by the individual service user's own needs, wishes and preferences (e.g. letting them choose their own daily routine).

[3] 1 mark: focus on the individual service user's own needs/wishes/preferences; 1 mark: involving the service user in decisions about their own care; 1 mark: a valid practical example of this in action. All other valid examples will be given credit.

Physical [4]: given his reduced mobility following the hip replacement, Pascal has a physical need for help getting around his home safely [1–2]; this could be met through physiotherapy to aid his recovery and rebuild strength and mobility, together with mobility aids such as a walking frame or grab rails to reduce his risk of falling [1–2].
Emotional [3]: Pascal also has an emotional need for reassurance and support to help manage his anxiety about coping at home alone [1–2]; this could be met through regular visits or contact from a support worker or family member, helping him feel safe and less isolated [1].
Final answer: physical need — mobility support (physiotherapy, mobility aids); emotional need — reassurance/support to reduce anxiety (regular visits/contact).

[7] Physical [4]: up to 2 marks for correctly identifying a valid physical need linked to Pascal's reduced mobility; up to 2 further marks for describing how it could be met (e.g. physiotherapy, mobility aids). Emotional [3]: up to 2 marks for correctly identifying a valid emotional need linked to his anxiety; 1 further mark for describing how it could be met (e.g. regular contact/support). All other valid needs, correctly linked to the scenario, will be given credit.

Physiotherapist [4]: assesses Pascal's mobility and designs an individual exercise and rehabilitation programme to strengthen the muscles around his new hip and improve his mobility [1–2]; provides ongoing sessions to monitor his progress and adjust the programme as he improves, helping him regain confidence and independence in moving safely [1–2].
Home care worker [4]: visits Pascal at home to help with daily tasks he may struggle with due to his reduced mobility, such as washing, dressing or preparing meals [1–2]; their regular visits also provide valuable social contact and reassurance, helping to reduce his feelings of anxiety and isolation [1–2].
Final answer: a physiotherapist supports Pascal's physical recovery/mobility through an individual exercise programme; a home care worker helps with daily personal tasks and provides social contact that reduces his anxiety/isolation.

[8] Marked as 2 × [4]. For each practitioner: up to 2 marks for a valid description of their role in general; up to 2 further marks for a description clearly applied to Pascal's specific needs (mobility recovery / daily living tasks and reassurance). All other valid practitioners (e.g. occupational therapist, GP) correctly applied to the scenario will be given credit.

Reablement is a short-term, intensive approach that helps a service user relearn skills and regain independence to carry out everyday tasks for themselves — such as washing, dressing or cooking — rather than having these tasks done for them. It typically involves a multidisciplinary team, such as occupational therapists and physiotherapists, working intensively with the person over a limited period (for example, around six weeks), with the specific goal of maximising their independence. Traditional home care, by contrast, usually involves ongoing, longer-term visits in which a care worker carries out tasks for the service user; this can be helpful in the short term but may not build the person's own skills and independence, and can create a longer-term dependency on services.
For Pascal, reablement is likely to be highly effective: it is specifically designed to help him regain the confidence and physical ability to manage independently at home following his hip replacement, empowering him and potentially reducing his need for ongoing services in future, which is also more cost-effective for services in the long run. However, reablement will not be suitable for every service user — for example, someone with a severe, permanent disability, or advanced dementia, may not be able to relearn skills in the same way, and may need ongoing traditional home care instead. Reablement also requires the person to be willing and motivated to actively participate in the programme, which not everyone may feel able to do immediately after a stressful hospital stay.
Overall, reablement is likely to be a particularly effective approach for Pascal specifically, given that his condition is a recoverable physical impairment following surgery rather than a permanent or progressive one; however, the appropriateness of reablement versus traditional home care should always be assessed individually for each service user, based on their specific condition, prognosis and motivation.
Final answer: reablement (short-term, intensive, aimed at relearning skills/regaining independence) is likely to be highly effective for Pascal given his recoverable condition, and is generally more empowering and cost-effective than traditional home care (which does tasks for the person); however, it is not suitable for everyone, particularly those with permanent or progressive conditions, or those not motivated to participate.

Levels of response (13 marks). Level 1 (Basic, 1–4 marks): limited, undeveloped comment on reablement and/or home care, with little application to Pascal's scenario; weak written communication. Level 2 (Adequate, 5–9 marks): describes reablement and traditional home care with some comparison and some application to Pascal's situation; adequate written communication. Level 3 (Competent, 10–13 marks): detailed, well-balanced evaluation comparing reablement and traditional home care, clearly applied to Pascal's specific circumstances, with a justified overall conclusion and consideration of when reablement may not be suitable; highly competent written communication and specialist vocabulary. Examples of suitable points to be included: reablement = short-term/intensive, aims to rebuild independence/skills; traditional home care = ongoing, tasks done for the person, risk of dependency; reablement well suited to Pascal's recoverable, post-surgical condition; reablement's cost-effectiveness/empowerment benefits; limitations of reablement for permanent/progressive conditions or unmotivated service users. All other valid responses will be given credit.

An informal carer is someone who provides unpaid care and support to a family member, friend or neighbour who needs help because of illness, disability, older age or a mental health condition [2]. An example would be a spouse, an adult child, or a close friend of the person needing care [1].
Final answer: an informal carer is someone (e.g. a spouse or adult child) who provides unpaid care and support to a family member, friend or neighbour in need.

[3] 1 mark: unpaid care/support; 1 mark: correct reference to a family member/friend/neighbour needing help due to illness, disability, older age or mental health condition; 1 mark: a valid named example of who might be an informal carer.

This is the Carers and Direct Payment Act [1] (Northern Ireland) 2002 [1], which gives carers the right to an assessment of their own needs and allows direct payments to be made to service users and carers so they can arrange and pay for their own care/support [1].
Final answer: the Carers and Direct Payment Act (Northern Ireland) 2002.

[3] 1 mark: 'Carers and Direct Payment Act' named; 1 mark: correctly identified as Northern Ireland legislation from 2002; 1 mark: a correct feature of the Act stated (e.g. right to a carer's needs assessment, or provision for direct payments).

Strengths [3]: informal care is often provided by someone the service user knows and trusts, such as a family member, which can help the person feel more comfortable and maintain their sense of dignity and familiar routine [1–2]; it can also be more flexible than formal services and is provided without direct charge to the service user [1].
Weaknesses [3]: informal carers often have no professional training, so they may be unable to safely provide certain specialist care, such as complex medical procedures [1–2]; the quality and consistency of care may also be affected if the carer becomes exhausted, unwell or unable to continue, since there is no guaranteed professional backup [1].
Final answer: informal care offers trusted, familiar, flexible, free support, but carers are often untrained (limiting the specialist care they can safely provide) and care can become inconsistent if the carer is unable to continue.

[6] Strengths [3] and Weaknesses [3]: up to 2 marks per subheading for a valid point with some development, plus up to 1 further mark for a second valid point/further development. Examples of suitable points: strengths — trust/familiarity, dignity, flexibility, no direct cost; weaknesses — lack of training, risk of carer burnout/unavailability, potential inconsistency. All other valid responses will be given credit.

Strengths [3]: statutory services (such as HSC Trusts) are funded from public funds, so they are generally free, or heavily subsidised, at the point of use for the service user, removing cost as a barrier to accessing care [1–2]; care is delivered by trained, regulated professionals, which can give service users confidence in the quality and safety of the care they receive [1].
Weaknesses [3]: statutory services can face long waiting lists and limited resources, due to high demand and constrained public funding, meaning service users may not receive care as quickly as they need it [1–2]; service users may also have less choice or control over exactly who provides their care, compared with arranging private care themselves [1].
Final answer: statutory provision offers free/subsidised, professionally regulated care, but is often limited by long waiting lists/resource constraints and offers service users less choice of provider.

[6] Strengths [3] and Weaknesses [3]: up to 2 marks per subheading for a valid point with some development, plus up to 1 further mark for a second valid point/further development. Examples of suitable points: strengths — free/subsidised at point of use, trained/regulated professionals, consistent standards; weaknesses — long waiting lists, resource/funding constraints, limited choice of provider. All other valid responses will be given credit.

Statutory provision, such as an HSC Trust, offers care that is generally free or subsidised at the point of use and delivered by trained, regulated professionals, but it can be limited by long waiting lists and constrained funding, which may be a particular problem for someone needing ongoing, long-term support. Private provision can offer greater choice, flexibility and potentially shorter waiting times, but the cost involved means access is unequal, and a service user or their family may not be able to afford private care indefinitely for a long-term condition. Voluntary organisations, such as disability-specific charities, can provide valuable specialist knowledge, peer support and advice, often at low or no cost, but their services rely on charitable funding and donations, which can be inconsistent, and provision can be patchy or unavailable in some areas. Informal carers, such as family members, can provide personal, trusted, flexible support at no direct cost, drawing on their close knowledge of the service user's needs and preferences, but they are often untrained, cannot provide some specialist or medical care safely, and are at risk of exhaustion or burnout over time, especially when supporting someone with a long-term condition.
For a service user with a long-term physical disability, needing ongoing rather than short-term support, no single type of provision is likely to be able to meet every need on its own. A combination of these different types of provision working together — often described as a 'mixed economy of care' — is likely to provide the most comprehensive and sustainable support: for example, statutory services might meet core assessed needs, a voluntary organisation might provide specialist peer support or equipment advice, an informal carer might provide day-to-day practical and emotional support, and private services might be used to fill any specific additional gaps the family chooses to pay for.
However, achieving good-quality, joined-up care in this way depends on effective coordination between the different sectors, for example through the care planning cycle, to avoid gaps or duplication in support; the overall quality of care experienced by the service user may also still depend heavily on their informal carer's own capacity and wellbeing, and on the local availability of voluntary and private options, which can vary significantly from area to area.
Final answer: statutory, private, voluntary and informal provision each bring different strengths and weaknesses; because no one sector alone can meet every need of someone with a long-term physical disability, a coordinated combination ('mixed economy') of these types of provision is likely to give the most comprehensive quality of care, though this depends on effective coordination, local availability, and the informal carer's own capacity.

Levels of response (15 marks). Level 1 (Basic, 1–5 marks): identifies one or two sectors of provision with limited, undeveloped comment; little synthesis across sectors; weak written communication. Level 2 (Adequate, 6–10 marks): describes strengths/weaknesses of more than one sector (including informal carers) with some development and some attempt to relate them to a long-term physical disability; adequate written communication. Level 3 (Competent, 11–15 marks): comprehensive, well-balanced analysis covering statutory, private, voluntary provision AND informal carers, clearly applied to a long-term physical disability, with a well-justified synoptic conclusion (e.g. mixed economy of care, need for coordination); highly competent written communication and specialist vocabulary. Examples of suitable points to be included: statutory — free/regulated but under-resourced; private — choice/flexibility but cost/unequal access; voluntary — specialist support but funding-dependent/patchy; informal — trusted/flexible but untrained/burnout risk; synoptic conclusion on combining provision and coordination via the care planning cycle. All other valid responses will be given credit.

(i) A Health and Social Care Trust is a statutory provider, since it is a public body funded and run by government.
(ii) A private nursing home is a private provider, since it is a commercial organisation that charges for its services.
(iii) A local branch of the Alzheimer's Society is a voluntary provider, since it is a charitable organisation.
Final answer: (i) statutory; (ii) private; (iii) voluntary.

[3] 1 mark for each correct categorisation: (i) statutory; (ii) private; (iii) voluntary.

(i) Putting the care plan into action is the implementation stage.
(ii) Checking, on an ongoing basis, whether the plan is meeting needs is the monitoring stage.
(iii) Making changes to the plan based on evaluation is the modifying stage.
Final answer: (i) implementation; (ii) monitoring; (iii) modifying.

[3] 1 mark for each correct stage named: (i) implementation; (ii) monitoring; (iii) modifying.

GP [3]: monitors Anne's general physical and mental health [1], diagnosing and managing any medical conditions [1], and can refer her to specialist services, such as a memory clinic or psychiatrist, if her dementia symptoms progress or other health concerns arise [1].
Social worker [3]: assesses Anne's needs [1] and coordinates and arranges the services and support she requires to remain safely at home, such as home care visits or day-care services [1], acting as a link between Anne and the wider range of statutory and voluntary services available to her [1].
Final answer: the GP monitors/manages Anne's health and refers her to specialists as needed; the social worker assesses her needs and coordinates the services that help her remain safely at home.

[6] Marked as 2 × [3]. For each practitioner: 1 mark for a valid general aspect of their role; up to 2 further marks for a description clearly applied to supporting Anne (e.g. dementia progression, remaining at home). All other valid practitioners (e.g. psychiatrist, community psychiatric nurse) correctly applied to the scenario will be given credit.

Voluntary sector [3]: an organisation such as the Alzheimer's Society could provide Anne and her family with information and advice about dementia [1], and access to local support or social groups specifically for people living with dementia [1], helping to reduce her isolation and providing specialist knowledge that statutory services may not always have time to give in the same depth [1].
Informal carers [3]: a family member, such as Anne's daughter, could provide regular practical support, such as help with shopping or household tasks [1], as well as emotional support such as checking in on her wellbeing and offering companionship [1], drawing on their close personal knowledge of Anne's preferences and needs [1].
Final answer: the voluntary sector (e.g. the Alzheimer's Society) provides dementia-specific information/advice and reduces isolation; informal carers (e.g. a family member) provide practical help and companionship based on their close knowledge of Anne.

[6] Marked as 2 × [3]. For each sector: 1 mark for a valid, correctly categorised example; up to 2 further marks for a description clearly applied to supporting Anne. All other valid, correctly categorised examples will be given credit.

Assessment: a social worker, or a multidisciplinary team, would assess Anne's current physical, intellectual, emotional and social needs, her level of independence, the safety risks of living alone with dementia, and her own wishes and preferences for her care.
Planning: based on this assessment, a care plan is drawn up setting out the specific support Anne needs — for example, daily home care visits, a referral to a dementia support group, and safety adaptations to her home — agreed together with Anne and her family wherever possible, in a person-centred way.
Implementation: the planned services are put into action — for example, a home care worker begins visiting, a referral is made to the Alzheimer's Society, and safety equipment, such as a personal alarm, is installed.
Monitoring: Anne's progress and the effectiveness of the plan are checked regularly, for example through review visits from her social worker or GP, to see whether her needs are being met and whether any new needs or risks have emerged.
Evaluating: at agreed review points, the care team assesses whether the plan overall has achieved its aims — for example, has Anne remained safe at home, and is she less isolated — and identifies any shortfalls.
Modifying: because dementia is a progressive condition, Anne's needs are likely to increase over time; the care plan would need to be modified accordingly, for example by increasing the frequency of home care visits, or eventually considering a move to residential or nursing care if her needs can no longer be safely met at home — after which the cycle begins again with reassessment.
Overall, applying the full care planning cycle to Anne's case shows that effective care planning is not a one-off event but an ongoing, cyclical process; this is especially important for a service user with a progressive condition such as dementia, since her needs will change significantly over time, and regular monitoring, evaluation and modification ensure her care remains safe, appropriate and person-centred as her condition develops.
Final answer: Anne's care would move through assessment (of her needs/risks), planning (a person-centred plan), implementation (services put in place), monitoring (checking the plan is working), evaluating (checking whether aims were met) and modifying (increasing/changing support as her dementia progresses) — an ongoing cycle that repeats as her needs change.

Levels of response (16 marks). Level 1 (Basic, 1–5 marks): describes one or two stages of the care planning cycle with limited application to Anne's case; weak written communication. Level 2 (Adequate, 6–11 marks): describes most stages of the cycle with some application to Anne's progressing dementia; adequate written communication. Level 3 (Competent, 12–16 marks): comprehensive coverage of ALL six stages of the care planning cycle (assessment, planning, implementation, monitoring, evaluating, modifying), clearly and specifically applied to Anne's case and to how her needs will change as her dementia progresses, with a well-justified overall conclusion; highly competent written communication and specialist vocabulary. Examples of suitable points to be included: assessment of PIES needs/risks; person-centred planning; implementation of services (home care, referral, safety equipment); regular monitoring/review; evaluation against the plan's aims; modification as needs increase (more support, eventual residential care); cyclical, ongoing nature of the process. All other valid responses will be given credit.