Managing Quality In Health And Social Care Social Work Essay

Managing feature In Health And Social C atomic round 18 Social employ Es feel out1.0 world to the CaseIn this assignment I am going to mathematical function a nurse pedestal for elderly house physicians, both(prenominal) male and egg-producing(prenominal) with both dementia and opposite medical exam conditions the desires of diabetes, Parkinsons infirmity and hypertension. some(prenominal) of the receipts customrs in this nursing nursing floor argon withdraw abut objet dart anformer(a)(prenominal)s argon mobile or self dep hold backant. It has two floors with 42 bed capacity.1.1 What tonus means to the following s tamp downholdersService practice sessionrs These be residents or clients in our Nursing home. Quality to our portion users means e rattling religious religious dish up that is offered to their satisfaction for exampleRespect Most of our residents prefer to be intercommunicate by the names while some prefer to be intercommunicate as Mr. or Mrs. We respect their wishes and this directs them happy. Also when we argon offering private business ilk washing or bathing we en confident(predicate) that doors argon shut for privacy and dignity purposes we too respect their age as adults and treat them as adults jibe to their wishesChoice Residents excerpts in our nursing home argon usu wholey observed as this makes them to provoke their freedom of choice in whatever they pauperization to rejoinder a leak for example we get under ones skin divers(prenominal) menu choices for foods and drinks and before we serve them we ask them what they prefer to capture. The same(p) applies to the dash they prefer to dress and so we offer them a choice on their own clothes and activities that they would the likes of to participate in and at the ratiocination of it all they argon happy and the woodland of expediency offered is satisfactory to them and bothbody else.Confidentiality Anything clienteleing a resident in our Nu rsing home is private and confidential unless for medical reasonablenesss like consultation and to those who ar concerned like family and relatives.Friends and family They usually deem when they atomic number 18 entang take in caution plans of their relatives and they be satisfied when what they have agreed on is followed through.Safety they are eer appreciative and adjuvant when they know that their parents and friends (residents) are free from defame by the administer they are provided with for example reliable from falls, abuse and infections deep down the nursing home. They like their relatives to be treated equally like other residents without discrimination because of either their conditions, disabilities or ethnicity. accusationrs These are the major answer providers in our nursing home and feeling to them meansEquity- all help providers should be treated equally disregardless of their race, ethnicity, gender and knowledge and skills they have on their pip eline when this is limit into amity they are move and tend to offer the outgo calibre of criminal maintenance to residents which in turn leads to customer satisfaction.Safety all expediency providers in our Nursing home ensure they are safe on the surroundings they mold on for their sake, residents, relatives and friends and apieceone concerned. We ensure straight-laced affairs are followed such as moving and handling by using proper equipment on residents like hoists and slings to avoid accidents to ourselves and to residents. Carers are al federal agencys happy when they are non abuse either by residents, relatives and friends or their fellow look atrs.We have four different models of feelTotal step management a way of managing mess and business processes to ensure complete customer satisfaction at either stage internally and impertinently (Department of Trade and Industry, DTI 2010). Although different quality experts punctuate different experts of this m ethodology, its major components stinker be summarised as follows processes, people, management systems and act measurement. tally to Ross and Perry (1999), in addition to creating delighted customers through empowered employees, number quality management processes also lead to higher revenue and let down cost. In our Nursing home, every department is involved in implementing quality management to offer the best quality of run we always usage as a team and ensure we have offered the best quality of concern that our residents study.Continuous quality al callent is a system that seeks to amend the pro batch of function with an emphasis on future results (Marshall, 2003). In our nursing home, the manager ensures that every service provider receives training, implements what they have learnt and they are administer if on that point is bring for retraining again we are retrained this ensures that we receive updated breeding to offer the best quality of service.Quality sta ndards The Care Quality delegation for England has produced a guidance to help providers of health and adult friendly dish out to comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009 (CQC, 2010b). This guide contains the regulations and the outcomes that the CQC expects people using a service impart experience if the provider complies. This forms the basis for the quality standards in wish well homes. in that respect are 16 core ones veer from respecting people receiving the go to prohibitative and suitability of premises and staveing levels just to mention a few. In my bearing setting, we get an annual inspection from UKAF over and above inspections from CQC and have been granted a star rating of three. All activities this year are geared towards a rating of four.Quality cycles According to QCC (2010b) quality cycles represent periods within which care homes should be re viewed to determine compliance in its service provision. This whitethorn be annually. However private organisations like the United Kingdom Accreditation service also offers a quality cycle inspection called the Residential and domiciliary care Benchmarking (RDB). The RDB annual quality cycle supports strategic planning by providing comparative feedback on a homes care provision and enables the identification of process gaps and cost/benefit assessments to be do (UKAF, 2010). In this model we have four major aspects to be looked into namely planning, doing, checking and acting.Quality and principles of carelegislating -these are laws and rules set by the government on how the provision of care should be for example protection of unsafe adults. In our nursing home, every service provider should be ready to protect all residents from any form of abuse we attend requisite trainings such as safeguarding vulnerable adults according to regulations by the CQC (2010b).Safety- in our nur sing home we always do risk of exposure assessment on every service user and consecrate measures in place like using bed rails to prevent falls by doing this we have protected residents from accidents and this ensures quality service to our residents.Independence-service users should be made in checker of their lives by allowing them to do some of the things like arranging their wardrobes, making and tidying their rooms by themselves because some of the residents are very active and would like to do what they used to do before and we always encourage them to do while we supervise them and this makes them happy hence promoting the quality of service as they are satisfied.Rights- service users should continue to enjoy the same counterbalances when in nursing homes like they used to when they were living nonparasiticly. Every service user supported in nursing homes has the right to say NO, right to have a relationship and the right to have a say in their care plan. Service provide rs always tend to balance service users rights against their responsibilities whether both are at risk or not.1.4) External agencies These are bodies that regulate quality of care includingThe Care Quality Commission an free regulator for health and well-disposed care in England (CQC 2010a 2010b). They regulate care provided by NHS, local authority, private company and voluntary organisations. Their aim is to make sure go care is provided for everyone. In our nursing home Care Quality Commission makes a minimum of three inspections annually (two announced and one unannounced) on such things as how we provide care in terms of cleanliness of the home and to service users.. It has a wide range of enforcement powers to take action on behalf of service usersif services are unacceptably low.TheCQC makes sure that the voices of service users are heard by asking people to piece their experiences of care services. It makes sure that users views are at the heart of its reports and review s. The CQC takes action if providers do not meet essential quality standards, or if on that point is reason to think that peoples basic rights or sentry duty are at risk (CQC, 2010) through a wide range of enforcement powers, such as fines and popular warnings, and can be flexible almost how and when to use them. It can follow up particular conditions in response to serious risks. For example, it can demand that a hospital ward or service is closed until the provider meets safety requirements or is suspended.The National Institute for Health and Clinical Excellence ( priggish)- this is an independent organisation responsible for providing national guidance on promoting good health preventing and treating ill health (NICE, 2010). In our Nursing home, residents who have anxiety, panic attacks point for sedatives in order for them to sleep they are usually reassured and kinda a government practitioner is consulted to review and advice them accordingly. Service providers take NI CE guidelines trainings on different medical conditions for example diabetic foot (identification and care of the foot).2.1) Quality StandardsBenchmarks According to Philip B. Crosby (1999) benchmarks are indicators of best exercise including access to care surroundings and the culture of a home. The Benchmarks is one of the most comprehensive sets of affectionate and environmental criteria and business performance indicators available (Daniels et al 2000). Our nursing home is accessible prevalentally, to wheel chairs, a spacious car park and a section for activities for residents and relatives. We also have a signing in visitors record book stating whom they are visiting.Code of institutionalise for social care workers and employers for social care workersThis document is developed by General Social Council and it contains agreed reckons of practice for social care workers and employers of social care workers describing the standards of conduct and practice within which the y should work ( GSCC, 2002). Employers use this set of code of practice to make decisions about the conduct of staff and support social care workers to meet their code of practice. Service users and members of the public use the codes to help them understand the behaviour of social workers (how they should behave towards them) and also how employers should support social care workers to do their job well. It is the responsibility of social care workers to make sure that their conduct does not fall down the stairs the standards set in the code of practice and no action or omission harms service users (NCSC, 2010). Social care workers moldiness protect the interests of service users, maintain confidence, respect rights, promote independence, be accountable for the quality of their work and take responsibility for maintaining and improving their knowledge and skills. The ecumenic social council expect social care workers to meet the codes and may take actions (deregistering) if regi stered workers fail.2.2) Different approaches to implementing qualityCommunication is a means of passing entropy from one person to another. In our nursing home we have different ways of communication like when doing care plans we always document what we have done for a resident so that whoever takes over knows what to do succeeding(prenominal) to ensure continuity of care. Also when handing over is done during change of shifts discipline about residents is shared and everyone is aware of any changes in care plans in accordance to CQC guidelines (CQC, 2010). We also have staff meetings where veritable culture is passed on and in cases where staffs have a problem it is addressed and solutions are granted out. For effective communication systems there should be a language that everyone understands.Policies and proceduresThese are guidelines set on how to do things often informed through regulations as describe in various government documents (GSCC, 2002 NICE, 2010 CQC, 2010a. 2010b). In our Nursing home we have different policies and procedures for example in cases of accidents to residents we are required to have a resident incident report and pass it on to the supervisory program families, friends and relatives are informed about the accident then precautions are put into place walking frames, to avoid future occurrences of similar accidents.Infection control indemnity helps to prevent parcel out of infections within our nursing home. We always use own(prenominal) protective equipment when offering personal care to residents, handling of any infectious wastes. We also use the proper technique for hand washing. on that point are also hand gels in each residents room, in public toilets and at the entrance of the building for sanitation purposes and all wastes like clinical and kitchen wastes are usually put in the bins ready for collection. In cases of disease outbreaks like diarrhoea and vomiting residents are isolated and managed separately and pr oper hand washing techniques are used to prevent further spread of the infection.Whistle blowing policy is designed to deal with issues that do not at one term expunge the employee and their employment but are a cause for concern in relation to the harm that may be done to other employees, residents or the wider residential district. Any employee who is concerned about their personal situation should domiciliate their concern with their line supervisor or manager. This policy is for reporting issues like elderly abuse, misuse of drugs, faulty machinery that may cause accidents, il sanctioned cast away of waste. The policy protects not only if employees but the wide community.Confidentiality- all residents or service users information is private and confidential. It is not a proper practice to discuss residents information in public like their conditions and behaviours by doing that is breaching the policy and legal action should be taken. In nursing homes all information is k ept safely and only accessible to relevant persons. This promotes quality of service2.3) Quality systemsISO 9001 involves a set of procedures that cover all key processes in the business, monitoring processes to ensure they are effective, keeping comme il faut records and facilitating continual avail. They have certain requirements like internal regulations, claims and procedures for residents, suggestion box and contract with uses. It also covers the importance of understanding and meeting customer requirements, communication, resource requirements, training and products, Leadership, occasion of people, Process approach, and System approach to management and Continual improvement (Tricker and Sherring- Lucas, 2001).In our nursing home for the provision of all these elements and reporting them on mean solar day to day basis for example there is a clear procedure for residents complains. Carers, residents and relatives are informed and logged in a special complaints book and comp lains are followed up. When all this are put into practice, there is employee and customer satisfaction, resulting from better specify and implemented business processes. As a result of this we have motivated staffs, who understands their roles and how their work affects quality, amend product and service quality, happier customers, and improved management and operable processes, resulting in less waste (both time and materials)Business excellence is a widely used framework that helps companies to review their performance and practices in a number of areas and identify targets and actions for improvement found on principles of customer service stakeholder value and process management ( British Quality Foundation, BQF 2010). Managers develop the mission, vision and values and are role models of a culture of Excellence. Studies in chinaware have shown that in care homes where this model is applied, managers are personally involved in ensuring the organisations management system i s developed, implemented and continuously improved are involved with customers, partners and representatives of society and also motivate, support and recognise the organisations people (Cheng B, Chang, C and Sheng L. 2005). In our nursing home we use a balanced distinguish card to keep track of activities by staff and measure consequences arising based on the British Quality Foundation model ( BQF, 2010).Service users families and relatives measure in a scale of 1-5 where one is poor and five is excellent. We work unstated in poorly rated areas to improve the quality of service. At the same time managers set a number of targets on key areas of each staff members roles which are then assessed on monthly review and awards are assumption to the best. This motivates other team members to work hard and best to attain the best and by doing so they provide best quality and we excel.2.4) Trainings this refers to a learning process that involves the acquisition of knowledge, sharpening o f skills and concepts (Stevens, 2004. In our nursing there are mandatory trainings offered to service providers before commencing to work like basic food hygiene, manual handlingHealthy and safety is ensuring that the environment where we are working is safe for service users, other staff and others in general by our actions and omissions. It is a responsibility to all staff to ensure that the environment is safe to work on. For safety purposes in our nursing home we do not use equipment unless it has been checked and serviced. Also default equipments are labelled DO not USE to prevent and avoid accidents. We also have controlled cupboards where substances that are speculative to health are stored and locked away. When there is a defect on the environment like chipped floors, loose hanging electricity wires we report to the maintenance coordinator and they are rectified immediately to avoid accidents. Again when housekeeping team are doing cleaning they always display cleaning boa rds and everybody is aware that cleaning is on circulate or the floor is wet and they avoid using it until it is ironic by doing this they minimise chances of accidents like falls2.5) According to Marshall (2003) and Stevens (2004), external and internal barriers to delivering quality are any obstacle which prevents a given over policy instrument being implemented or limits the way in which it can be implemented. They includeResources lack of adequate resources hinders quality of service for example inadequate or shortage of staff affects the quality of services offered and this leads to unsatisfaction of service users as they get services that are not adequate and for service providers because they are overworked. In nursing homes when there are staffs shortages they ordinate cover shifts earlier by either bank staff or some agencies registered with the home. Financial barriers include budget restrictions like food supplies and other supplies like incontinent products limits th e overall expenditure and this leads to inadequate provision of quality services to residentsPersonal Appearance Hygiene and grooming, eating habits and attire can vary from country to country and culture to culture. For example, some people may wear attire such as a headdress as part of their custom and beliefs. To remain true to their beliefs, some workers may want to continue to wear this dress at their workplace. Employers may view this as inappropriate or unsafe. It is particularly problematic in workplaces where workers wear uniforms. worship In many cultures, religion dominates life in a way that is often difficult for employers to understand. For example, workers from some cultures may want to pray while at work times in accordance with their values and beliefs. in that respect may also be religious holidays on which people of certain religions are forbidden to work. These differences aim to be respected, where possible, and not ignored and they affect the quality of servi ce.Language barriers often go hand-in hand with cultural differences, seance additional problems and misunderstandings in the workplace. When people cannot communicate properly they are bilk when communicating with supervisors, co-workers and residents this can be dangerous because people may end up performing poorly in their work thus bear on quality of service offered.Legal and institutional barriers -these include lack of legal powers to implement a particular instrument and responsibilities which are split amongst agencies limiting the ability of an institution. Like the law states that students should work for twenty hours only which creates shortages at work affecting quality of services.3.1) According to Business Dictionary.com (2010), policies are principles, rules and guidelines formulated or adopted by an organization to reach its languish term goals. They are designed to influence and determine all major decisions, actions and activities take place within the boundar ies set by them and procedures are specific methods employed to express policies in action in day to day operations of the organization. For example, in nursing homes the National Care Standards Commission for England, NCSC (2010) has outlined requirements that these homes must meet which in effect guide their policies and principles. These policies include, but not limited to manual handling procedures, Risk assessment and Infection control.manual of arms handlingThese are techniques used to handle or move service users like hoisting, using belts and sliding sheets to move residents these are safe procedures for both residents and service providers as they minimise accidents to both cases and this promotes quality of service (CQC, 2010). On the other hand, they have disadvantages like time consuming when doing procedures like hoisting which requires two or three persons and also residents may not like the experiences of hoisting and thirdly it needs trainings to be carried out.Ris k assessmentsAccording to healthy and safety at work act (1974) the Management of Health and Safety at endure Regulation (1999) states that it is the responsibilities of managers to do risk assessment to employers and employees. to reduce and prevent risks to them in future and they are included in their care plan so that quality of care can be improved for example residents with risks of fall have walking frames, falling mats and bed rails put in place to avoid falls but again things like bed rails have caused accidents in that residents are trapped and some apply fractures which affect quality of service3.2) factors that influence the achievement of quality of personal careQuality is a difficult concept to capture directly. However, resident or organisational outcomes are often used as a deputy for quality (Marshall, 2003). There is considerable debate about the relationship betwixt quality of care and quality of life as joint, but not necessarily competing, measures of quali ty. A study for the Joseph Rowntree Foundation indicates that residents perceptions of nursing staff are a good indicator of quality of care (JRF, 2008).The importance of measures of social care and of homeliness epitomise the divide between health and social care provision in care homes. Factors influencing residents satisfaction with care are discussed belowTeam workingHeath care workers working in teams has been recognised as an improving the quality of care (Stevens, 2004 Borill et al 1999). According to Stevens, the intention is for carers to share tasks and learn from each other and possibly improve based on their experiences. This can be illustrated by the quotation belowThe best and most cost-effective outcomes for patients and clients are achieved when professionals work together, learn together, lock up in clinical audit of outcomes together, and generate innovation to ensure progress in practice and service. (Borill et al 1999 p.6).Stevens has for example reported from a number of surveys from UK nursing homes to suggest that there is a reduction in carer tear and significant reduction in stress when staff work in teams resulting in better coping and satisfaction. Both these studies (Stevens, 2004 Borill et al 1999) found that service users surveyed showed more satisfaction when carers and health workers worked in teamsHealthy and safety at workThe responsibilities of care home proprietors are subject to a range of health and safety legislation among them the Health and Safety at decease etc. Act 1974, the Management of Health and Safety at Work Regulations 1999 which require employers to assess the risks to employees and other who may be affected by their undertaking, (residents) and the control of Substances Hazardous to Health Regulations ( Care Quality Commission, 2010).These regulations have led to dramatic improvements in the safety of residents and people working in care homes according to the care quality commission. For instance, guideli nes requiring minimalist manual handling has significantly reduced the numbers of health workers staying off work due to unwellness which has a positive effect on the level of personal care of residents ( CQC, 2010a). However, a report for the Joseph Rawtree Foundation (JRF, 2008) showed that the percentage of medical specialty errors and adverse events in nursing homeshave increased despite regular inspections by the CQC. Stevens (2004) has also reported survey results from 27 residential homes with dementia patients where 19% cases of medication errors were reported.In my care setting, clear improvements can be seen from less harm to residents when using the hoist but not many service users like to use the hoist. Some risk assessments in care homes have made it very difficult to take residents outdoors or even for activities outside the home for fear of not meeting the Health and safety requirements and this ends up reducing the quality of care.3.3 The following recommendation c an improve the quality of care in Nursing homesTraining /educationThis means getting knowledge and skills or new information on how to do things according to the recommended regulations and standards ( Stevens 2004). This is a very important aspect in nursing homes all trainings as it provides ongoing trainings to update service providers and equip them with relevant and flow information that enables them to provide the best quality of care that will be satisfactory to service users. In our nursing home trainings are offered and need to be implemented then supervision is done and in cases where need for retraining arises, arrangements are done and they are offered for the benefits of service users, service providers and the community at large as it reduces or minimises preventable accidents and this promotes the quality of serviceReviewThis means going through the set of targets or think activities to see the progress whether it is improving or getting worse. This alerts and acti ons or precautions are put in place to make the situation improve for better quality of service ( Stevens, 2004). For example in our nursing home there are always monthly reviews of care plans of service users this includes individual or family interviews to determine whether residents are improving or need some improved care plans like in moving and handling procedures (use of hoist or belts) and then action is taken accordingly. Also for staff there is every quarter staff meetings or when need arises and previous discussed or current issues are raised and a way forward on how to carry on is agreed. There are always individual supervisions done by allocated persons and each employee identifies areas that need improvement and good performing areas by doing this there is improvement of quality of serviceConclusionIt has been shown that in order to improve services to users in the social care sector, it is important to follow principles, guidelines and procedures set by government, in dustry bodies or even individual homes. There is also need for planning, doing and checking and then reviewing to assess shortcomings in order to design improvement regimes. Similarly, it has been shown that although there is legislation and care industry standards, it will require long term commitments in developing methods, instruments and communication procedures involving all stakeholders at care or residential home level.