MATSEC SEC Health and Social Care cheat sheet

Care values (empowerment, dignity, respect, independence, safety, privacy) underpin all practice; the Maltese care sector is regulated by the Care Quality Commission (CQC Malta) under the Care Quality Act.

Maslow's hierarchy (physiological, safety, belonging, esteem, self-actualisation) is used to identify unmet needs; lower needs generally take priority when resources are limited.

Erikson's psychosocial stages: trust vs mistrust (infancy), autonomy vs shame (toddler), initiative vs guilt (preschool), industry vs inferiority (school age), identity vs role confusion (adolescence), intimacy vs isolation (young adult), generativity vs stagnation (midlife), integrity vs despair (older adult).

Piaget's cognitive stages: sensorimotor (0-2), preoperational (2-7), concrete operational (7-11), formal operational (11+); object permanence develops in the sensorimotor stage.

Bowlby's attachment theory: secure attachment in early childhood supports later emotional regulation; prolonged separation can cause distress and, if severe, developmental delay.

The care planning cycle: assess needs, plan outcomes, implement, monitor, review - each stage documented and reviewed with the service user and, where appropriate, family.

Person-centred care means the individual's preferences, history and goals shape decisions; consent must be informed, voluntary and given by someone with capacity.

Safeguarding categories include physical, emotional, sexual, financial, neglect and discriminatory abuse; a concern must be reported to the designated safeguarding lead immediately, not investigated by the carer.

Confidentiality is limited: information is shared on a need-to-know basis and may be disclosed without consent where there is risk of serious harm, or under legal duty.

The six Activities of Daily Living (ADLs) commonly assessed: washing, dressing, feeding, toileting, mobility and transferring; Instrumental ADLs (IADLs) include shopping, cooking, cleaning and managing money.

Vital sign reference ranges for adults: temperature 36.1-37.2 °C, pulse 60-100 bpm, respiratory rate 12-20 breaths/min, blood pressure around 120/80 mmHg, oxygen saturation 94-100%.

Infection control: hand hygiene (WHO five moments), PPE selection, safe disposal of sharps, and isolation of infectious patients reduce cross-contamination; standard precautions apply to all service users.

Pressure ulcer risk is assessed using the Waterlow or Braden scale; repositioning, skin inspection and adequate nutrition reduce risk.

Malnutrition screening tools (e.g. MUST) use BMI, unintentional weight loss and acute disease effect to score risk; a score of 2 or more triggers a care plan.

Medication principles: the 'rights' include right person, drug, dose, route and time; errors must be reported through the incident reporting system and documented.

The Mental Capacity Act principles: assume capacity, support decision-making, accept unwise decisions, act in best interests, choose the least restrictive option.

Deprivation of Liberty Safeguards (DoLS) protect people who lack capacity and are under continuous supervision and control in a care home or hospital; authorisation is required before restriction.

Health promotion models: the biomedical model targets prevention and treatment; the social model addresses determinants such as housing, income, education and social support.

The biopsychosocial model considers biological, psychological and social factors together; a holistic assessment addresses all three.

Stages of grief (Kübler-Ross): denial, anger, bargaining, depression and acceptance; not everyone passes through all stages or in this order.

Communication skills: active listening, open questions, paraphrasing, reflecting feelings and summarising; closed questions are used to confirm facts.

Barriers to communication include sensory impairment, language differences, physical environment, emotional state and cognitive impairment; interpreters and communication aids can address these.

Equality means equal treatment and opportunity; equity means fair treatment adjusted to individual need; diversity recognises differences and inclusion ensures participation.

Legislation relevant to Maltese practice includes the Care Quality Act (2019), the Mental Health Act, the Child Protection Act and data protection law; policies must align with these.

Reflective practice (e.g. Gibbs' reflective cycle: description, feelings, evaluation, analysis, conclusion, action plan) links experience to improved future practice.

Teamwork: multidisciplinary teams (MDT) include doctors, nurses, social workers, physiotherapists, occupational therapists and psychologists; clear roles and shared records reduce duplication and error.

Risk assessment balances the likelihood and severity of harm against the benefits of an activity; a risk enablement approach supports independence rather than avoidance.

Human rights principles: dignity, fairness, equality, respect and autonomy; the European Convention on Human Rights and Maltese law protect these in care settings.

Child protection: safeguarding children requires recognising signs of abuse (unexplained injuries, changes in behaviour, fear of a particular adult) and following local referral procedures.

Elder abuse risk factors include social isolation, carer stress, dependency and cognitive impairment; screening and support for carers reduce risk.

Nutrition and hydration: older adults need adequate protein, calcium and vitamin D; dehydration risk rises with age due to reduced thirst sensation and medication effects.

Falls prevention: strength and balance exercise, medication review, vision checks, home hazard assessment and appropriate footwear reduce falls in older people.

Dementia care: person-centred approaches, validation, routine and environmental modification reduce distress; antipsychotic medication is used only when non-pharmacological approaches fail.

End-of-life care principles: dignity, pain and symptom control, advance care planning and support for family; palliative care aims to improve quality of life rather than cure.

Record keeping must be accurate, legible, dated, signed and contemporaneous; records are legal documents and may be used in investigations or court.

Whistleblowing protects staff who report unsafe practice; the Public Interest Disclosure Act principles and Maltese law protect good-faith disclosures from retaliation.

Anatomy and physiology basics: the cardiovascular system transports oxygen and nutrients; the respiratory system exchanges gases; the nervous system coordinates body functions.

Common chronic conditions: diabetes (type 1 autoimmune, type 2 lifestyle-related), hypertension, asthma, COPD, arthritis and dementia; each requires condition-specific care planning.

Diabetes monitoring: HbA1c reflects average blood glucose over 2-3 months; hypoglycaemia (low blood sugar) presents with sweating, tremor and confusion and requires fast-acting carbohydrate.

Infection prevention: the chain of infection (infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host) guides control measures.

Safeguarding adults: the six principles are empowerment, prevention, proportionality, protection, partnership and accountability.

The care worker's role boundaries: only perform tasks within training and competence; escalate concerns to a registered professional rather than acting beyond scope.

Ethical principles: autonomy, beneficence, non-maleficence and justice guide decisions; conflicts are resolved through discussion and, where necessary, ethics committees.

Social determinants of health: income, education, housing, employment and social networks influence health outcomes; addressing these is part of public health and social care.

The Maltese health and social care system includes public services (Mater Dei Hospital, primary health care), private providers and NGOs; coordination across sectors is essential for continuity of care.