Culturally Safe Practices and Cultural Safety Plans; what are they, and why they are necessary?
As a multicultural country, many of Australia’s citizens originate from a variety of countries around the world (It is estimated that over 20% of Australians were born overseas). They have brought with them diverse lifestyles, foods and cultural practices. This diversity has added to our overall identity within the Australian culture however, with continued immigration and the recognition of cultural heritage or identification, there is the need to address the cultural needs and preferences of individuals when providing care and support.
From an organisational viewpoint, culturally safe practices aim to meet the diverse and individualised needs of clients who come from, or identify with, another culture.
Recognise the individual first.
Before we dive into cultural safety plans and practices we should always recognise that quality care is not just about overlaying elements of a person’s cultural background onto their care. Empowering clients to actively participate in the care planning process is essential to providing a quality service. Letting clients know that they are valued, respected and understood, irrespective of their ethnicity or cultural differences should be at the forefront of care planning and delivery. It’s the recognition of the individual in us all.
If the individual is so important why is there a focus on cultural identity?
Our individual backgrounds, our inbuilt need to understand the motivations of others, to feel safe in the world, has shaped us and our thought processes, it leads us to seek out those who are similar to us; those whose motivations we understand are ‘safe’. This creates in us an automatic bias towards the familiar, and against others who challenge our ideal of ‘normal’. This includes people who dress differently, who hold different beliefs to us and who may speak a different language. Of course recognising this bias is the basis for moving forward in providing culturally safe care and support.
Care services need to recognise and respect the cultural identities of others (clients and staff) and safely meet their needs, expectations and rights; avoiding stereotypical barriers and efficiently addressing any issues of bias or discrimination if, or when it arises.
Knowledge is a key ingredient in providing culturally sensitive support to an individual. Services can utilise the resources provided by organisations such as the Centre for Cultural Diversity in Ageing. Their website provides insight into many of the different cultural groups in Australia, their collective history and cultural norms. By using this general cultural information, organisations and their staff can seek to deliver a more culturally appropriate and safe service.
Program Requirements around Cultural Safety
Some program standards, including the NATSI Flexible Aged Care program, include the need to develop cultural safety plans and it appears, from the draft standards review, that the new Aged Care Standards that will be introduced in 2018 have incorporated the need to cultural safety in recognition of the specific needs of cultural groups including the LGBTI community. We are also seeing the concept of cultural safety embedded into training packages.
However, when I talk to people, or do a Google search, there are few examples of Cultural Safety Plans, so what are they?
Cultural Safety Plans
To start with, there is no clear template for the development of a cultural safety plan. To understand what a plan might include we need to turn to research and the genesis of the idea of cultural safety in care that originated in New Zealand in the 1990’s. Research at that time indicated that the acknowledgement and support of culture in the health arena was an important part of meeting the physical, social and emotional needs of patients when providing health care to First Nation peoples. Through this recognition came empowerment of the individual as the driver of their care plan and from it, the idea of incorporating cultural safety into care plans.
A Cultural Safety Plan is the key to acknowledging a respect for the individual needs of clients. They demonstrate a commitment to providing a culturally safe environment for clients and to delivering culturally appropriate care and support services. The plan, as with all care plans, is developed in collaboration with the client and their carer or family. This makes sense as they are the holders of relevant personal information, which can help organisations identify and cater to individual cultural preferences, requirements and activities.
What should a Cultural Safety Plan include?
For a number of organisations the elements of a cultural safety plan may already be included in a general care plan; it does not need to be an addendum or extra form. In an organisation that caters specifically to one cultural group, elements of a cultural safety plan may be embedded into organisational practice, policies, procedures and other documents. There may be an over-arching cultural safety plan developed and held by the organisation.
Where an organisation supports a wide diversity of clients, including those from a Culturally and Linguistically Diverse or LGBTI background, there may be a requirement for the development of additional individual cultural safety plans.
With no clear definition of what should be included in a cultural safety plan I have had to fall back to our work with rural and remote services. So here is my take on what a cultural safety plan should include, you might also have other ideas of what should be included based on your individual organisation and the clients you support, use it as a jumping off point.
Cultural Safety Plans could include, but are not limited to the following:
- Historical information relating to the cultural group the individual belongs to (massacres or forced relocation away from land or country).
- Historical information relating to the individual (e.g. stolen generation linkages, war survivors or care leaver).
- Language preferences, including acknowledging first languages.
- Acknowledging the cultural preferences around medical interventions.
- Acknowledgement of the cultural preferences around death and dying.
- Recognition of food preferences including preparation and eating (e.g. Vegetarian, Halal or Kosher).
- Acknowledgement and respect of religious practices and rites including those around responding to death/funerals, coming of age/men’s business and cultural ceremony.
- Recognition of preferred activities.
- Acknowledgement of the title of the individual or their preference of sexual identity.
- Recognition of care worker preference – cultural background, language or sex.
Ensure Staff Understand the Importance of Upholding the Plan.
It’s all very well having a cultural safety plan; implementing it is another thing. Ensuring your staffed are trained and equipped to provide culturally appropriate care is equally important.
Cultural Safety Plans at an organisational level should be reviewed annually through discussion with cultural leaders and/or staff from the cultural group. Individual cultural safety plans should be checked at the time of the care plan review with the family and the individual to ensure the continuation of culturally appropriate support services.
I hope this is of help to you as you develop or work to cultural safety plans in your organisation. If you would like support to develop cultural safety plans or incorporate this information into your organisation's policies, procedures and documents give us a call or send an email, the details are found in our contact page.
Interested in more like this? Check out our posts on Diversity