Improving Healthcare at Fleetwood Hall Home: Policies, Legislation, and Person-Centered Care

implementation of policies and legislation in Fleetwood Hall home is crucial for ensuring efficient and person-centered healthcare. Effective communication, accountability, training, and adherence to guidelines are key principles for improving care quality and patient safety. A comprehensive planning process, including needs assessment and regular feedback, should be followed to address patient needs and enhance the care environment. Redesigning policies and procedures can bring positive changes, ensuring equal care, safety, and wellbeing for all residents. The use of relevant theories, such as Erickson's psychosocial developmental theory and Bandura's social learning theory, can guide the type of care needed in the facility.

Running head: HEALTH CARE
HEALTH CARE
Name of the University
Author Note

1HEALTH CARE
LO 1:
1.1 Some of the main principles of support applied to health care are the promotion of
effective communication, promotion of antidiscriminatory practices, maintenance of the
confidentiality of the information, supporting the rights of dignity, decision making and
empowerment, acknowledging the personal belief of the person and respecting the
diversity of the patient, protecting individuals from abuse and provision of a person
centred care (Mitchell and Golden 2012).
It is evident from the case study that the registered nurses and the care staffs working
in the Fleetwood health care unit did not have effective communication between each ,
other the residents of the home and the families. Due to lack of communication with the
families and their grievances they lacked information about how residents were deprived
of their basic rights. At the time of the inspection, the inspection team found assessment
and the care records that were not patient centred and the discrepancies were not
identified at the time of the internal audit, hence failure to provide a person centred care
(Morgan and Yoder 2012). Again, the case study clearly reveals that people and the
families were never involved in the decision making process for the service improvement,
thus breaching the code of conducts by not involving the clients and their families in the
decision making process.
Principles of care could be applied to the Fleetwood Hall home by conducting regular
audits and regular feedbacks from the residents of the care homes. Representatives of the
patients should always be included while taking decision for quality improvement
strategies. In order to preserve the rights of the patient, it is necessary to conduct activities
or programs that address their needs and not on the convenience of the staff members
(Combes and Azema 2013).

2HEALTH CARE
1.2. Harm can be referred to as injury, both physical and mental, which has been
inflicted intentionally. Some of the examples that can be gathered from this Fleetwood
hall home scenario, related to patient harm are- Lack of safety for the women residents.
Although there were separate mental health units for the male and female, but they had to
share the same lounge area and the bathroom. Although separate bathroom signs were
placed outside the toilets for the male and the female, but many people with the mental
health problems might not adhere to this due to problems associated with memory.
Furthermore, there was lack of trained personnel and there were numerous incidents
reports that required safe guard concerns but, was not taken care of. Again, errors were
found in the storage, administration and monitoring of the medicines. Errors in
medications dosages and administration might lead to fatal life threatening conditions.
In order to mitigate this problem, induction or regular training has to be conducted in
order to educate and delegate the tasks to each of the care staffs, the care staffs should be
selected as per their competency level (Curran 2014). Monthly audits should be made to
identify the gaps and the loops. Separate spaces and toilets should be made for the male
and the female. Patients having problems with the processing of memory should be
accompanied by a carer while accessing the bathroom or the lounge areas Proper risk
registers should be maintained to keep a record of adverse incident and should be tallied
with previous reports in order to understand improvements (Borsonet al. 2014). The
flooring of the mental health units needs modification in order to ensure a smooth
movement of the mobility aids. Special attention should be given to the infection control
procedure, medication administration procedures, medication storage and waste
management.

3HEALTH CARE
1.3. A person centred approach in health care refers to focussing on the needs, desires and
goals of individual patients.
One of the important step for a person centred approach is to build an effective
communication system between the service users and the service providers. Effective
communication helps e health care staffs to understand the unaddressed needs of the patients.
Furthermore, in most of the cases the residents of the home were not involved in the person
centred approach. The patient or the representative of the patient should be involved in the
improvement planning of the home. Regular feedback has to be taken from the residents to
develop a person centred care plan. The recreational activities for the residents of the home
should be made as per the needs of the patients. Patient autonomy is one of the important
aspect of a person centred health care. Hence it is necessary to teach staffs regarding the
consent seeking procedure from the patients. Development of trust and the therapeutic
relationship between the staff members and the patients are necessary for a person centred
care. Special assessment teams should be made such as geriatric assessment team. It is
evident from the case study that the female required separate dwelling space, hence
arrangements should be made to separate the male and the female wards.
1.4. Ethical dilemma can be considered as a moral situation or a decision making problem
between two moral decisions, where obeying one might transgress another.
The case scenario 1 reveals that Mrs. Y is a 70 years old patient, who was suffering
from Alzheimer’s disease. Mrs. Y had suffered from a fall and had bruised herself. Mrs. Y
was supposed to keep the straps of the wheel chair on, in order to ensure safety, however she
does not like to keep the straps on. Health care workers are accountable to patient autonomy
and pay regards to their wishes in the best possible way. According to article 8, wellbeing ,
choice , dignity are the basic rights of the patients. The care workers in this scenario might

4HEALTH CARE
have considered the wish of Mrs. Y. Susan who has rightfully raised the flag of concern and
have advised the care workers to put the straps on is of the misconception, the she is not
being listened to, since she is not the relative of Mrs. Y. Hence, the care workers might fall
under an ethical dilemma as whether to listen to Susan or the patient’s relative or to the
patient herself.
Ethical frameworks can be helpful for making ethical decisions in case of a dilemma.
A utilitarian approach should be used in this case. As per the Utilitarian approach, the best
action is to do good to the patient or any actions should inflict minimum harm to the patients.
In this case although, the care giver had tried to preserve the right to autonomy in the patient,
he should also consider, that his actions will not impose any harm to the patient. According to
the duty based approach or the deontological theory, everyone has certain duties to fulfil and
fulfilling this duties is a moral requirement. Hence a health care staff should ensure that his
actions are beneficial or safe for the patient.
Task 2
2.1. It is necessary to demonstrate that the care homes are operated in an efficient manner. It
is necessary to ensure a uniformity in the decision making procedures. An appropriate
framework should be made for the planning and the implementation of the policies. Codes of
conduct should be set for health care workers as it guides them to provide a safe and
guaranteed care and support. The codes of practice for the health workers ensures that they
should be accountable to the promote privacy, dignity, rights, health and wellbeing of the
people. Professional communication between the staff members are necessary for a
continuous improvement of the care home. Some of the other legislation and the policies that
can be applied to Fleetwood care system are abiding by the health and the social act, the

5HEALTH CARE
medical devices regulation act, the pharmacy order 2010. The food safety and hygiene
regulation act 2013 and the human right act. All the staffs’ members should be educated
about the guidelines. Regular checks should be made such that the care homes abides by the
legislations. Incentive systems can be introduced for making things to work. As a manager it
is necessary to monitor that the food quality is the adhering to the NHS dietary guidelines or
are being approved by a registered dietician. The Health and safety work regulation 1990,
ensures that the workplace is protected for the employees and the clients. It ensures that the
health care workers are provided with personal protective equipment and all the workers
abide by the guidelines. For example, the food requirements of the frail patient will not be
same as that of the normal elderly adults. It is necessary to develop human rights within the
care home. The manager should ensure that health care needs the vulnerable groups are
addressed properly. Assistive aids should be made available for the residents with disability.
The staffs of the Fleetwood hall home should be trained for developing cultural sensitivity,
such that the diverse care needs of the ethnic minorities, women and the LGBTQ
communities are met. The home environment should be inclusion friendly. This might require
provision of special aids like mobility aids, of hearing aids or visual aids, provision of
wheelchairs. It should be mentioned that the basic rights of most of the patients with mental
health problems are breached as in all of the cases these patients or their representatives are
not involve in the decision making process. Hence, Fleetwood would foster equal care in the
organisation for the mental health patients by a regular counselling by the psychotherapists.
Some of the criteria for the health and the social act are provision of a clean and infection free
environment, suitable communication between the service users and the service providers, a
regular risk assessment program.

6HEALTH CARE
2.2. A comprehensive planning is required for the implementation of the policy legislation in
the Fleetwood hall home. Effective SMART goals can be prepared for a successful planning
of the policies. A thorough needs assessment programme and feedback should be taken in
order to understand the needs of the patient. Weekly surveillance program should be
conducted to understand the grievances of the patients. The implemented plan should be
approved by lawyers and the supervisors to ensure that all the litigations are met.
2.3. Redesigning the policies and the procedures for the Fleetwood Hall home should bring
about drastic positive changes in the environment of the care homes. Abiding by equality act
would ensure equal care for all group of people. The policies, legislation and the codes of
conduct are meant to ensure safety and wellbeing of the patients. The set of guidelines help
the workflow to proceed in a systematic way (Tappen 2016).
In health and social care, the development of the policies are important as they ensure
the preservation of the human rights, demonstrate equality among the service providers and
the service users (Kemppainenet al. 2016). For example, the health care workers abiding by
the five moments of hand and hygiene will ensure that no infection is spread from them to the
clients. Hence less complaints will be lodged by the residents. There will be less occurrence
of adverse events such as slips and falls. Safety measures should be considered while
handling, storing and the administration of the medications. The guidelines and the policy
would ensure a clean care home with almost no report of infections. Guidelines would ensure
that the staffs remain adhered to the protocols of medication safety and storage, use of the
personal protective equipment and the dietary guidelines. The residents would report less or
almost no complaints of the quality of care. Introduction of the legislation and the policy
procedures would keep the staffs dedicated to the work as non –adherence to the guidelines

7HEALTH CARE
might cause penalty. Redesigning a culturally sensitive policy would ensure that a culturally
sensitive workforce is there to address the needs of the vulnerable population.
Alterations in the legislation and the policies can increase the cost incurred in a year,
for example the cost associated with the reading and understanding and the complying with
the laws. Training and educating the staffs would require to hire some educators. If specific
complaint portals are made, then they might end up in the courts, thus adding up the cost.
Redesigning of the entire care homes, such as changing the flooring and the making it
suitable for the one with disability would require costs. Again, kit is necessary to introduce
ICT for the documentation of the patients’ records or other administrative task. Importing
medical device, computers would incur costs that can be difficult to manage for small health
care organisations. Moreover the codes of conduct, the policies and the legislation would
provide a systematic flow of workforce and ensure a quality care for the residents of the
home.
LO. 3
3.1. The two theories that can be used to describe the situation and the type of care needed for
the Fleetwood care home is the Erickson’s psychosocial developmental theory and Albert
Bandura’s social learning theory. The theory has been developed based upon the
psychosocial needs of the individual conflicting the requirements of the society. As per the
theory, the successful completion of the stages results in the formation of a healthy
personality and acquisition of the main virtues of life .Failure to complete each of the stages
of life can lead to reduced ability for the completion of the further stages and unhealthy
personality and the sense of self (Cherry 2012). Since, most of the residents of the Fleetwood
care home are of above 50 years age, it is necessary to be concern about the seventh stage and
the eighth stage of the psychosocial development - Generativity versus stagnation. The stage

8HEALTH CARE
takes place at the time of the middle adult hood (ages 40 to 65 years) . As a carer it is
necessary to create or nurture care to the patients by creating positive changes benefitting
other people. Providing appropriate care to the patient and helping them to improve their
quality of life, ultimately helps them to assimilate in to the community (Cherry 2012). For
example, the provision of appropriate assessment and treatment to the patients with mental
health problems or with disability helps them in social inclusion. It has been already
mentioned earlier, that residents of the Fleetwood hall home experience least autonomy while
deciding their plan of c care or even the do not get the autonomy to decide the recreational
activities(Cherry 2012). According to Tappen (2016), autonomy leads to the feeling of the
accomplishment and usefulness. By failing to find the way to contribute or to take part in the
decision making process, a person might become stagnant and feel unproductive. An
individual might feel disconnected or uninvolved. Engaging the clients in various activities,
taking part in the decision making process helps the clients to recover fast and get involved in
the community activities. Ego Vs. despair is the final stage of the Erickson’s theory of
psychosocial development. According to Erickson, if people lives see that their life to be
unproductive, and feel guilt about the past or feels devalued, people on their last years might
feel dissatisfied with life and develop despair leading to despair and the hopelessness
(Darling-Fisher 2018). Thus treating clients equally irrespective to the race and the cast,
preserving their dignity and integrity, providing them with the right to take decisions about
their own life enables elderly people to look back at their life with a sense of completeness
and closure and also accept death peacefully (Darling-Fisher 2018).
Cognitive theories are fundamental to enable problem solving and the ability to
comprehend and apply principles in a variety of situations. The social learning theory of
Albert Bandura focusses on the personal characteristics of the learners, the environment and

9HEALTH CARE
the behaviour patterns. Role modelling can be considered to be the central concept of the
learning theory. For example, an experienced nurse who exhibits desirable professional
attitudes and the behaviours acts as mentors for a less experienced nurse. Hence, it is
necessary that the experienced care workers of the Fleetwood hall home guides the novice
health care workers to abide by the protocols and the guidelines. Again, the health care
workers should find the way to encourage the competent feelings of the patient to promote
the health and wellness rather than fostering the sense of dependency and low self-worth and
helplessness.
3.2. Social processes can be defined as the forms of social interaction leading to the
formation of the social relationships. A variety of social interactions can be perceived such as
the conflict, cooperation, competition and accommodation (Viruell-Fuentes, Miranda and
Abdulrahim 2012). Social processes like isolation, marginalisation, unemployment,
bereavement, poor health, disability, lack of education affect the type of care provided to the
service users. For example, the occupation determine the social class and people belonging
to lower social class are likely to receive low quality of care. Social workers often express
negative thoughts for these patients (Viruell-Fuentes, Miranda and Abdulrahim 2012). Again
a patient belong the other ethnic minorities might be demeaned by the other residents and
sometimes it is the care workers who actually face the difficulties in providing equal care to
all the patients (Viruell-Fuentes, Miranda and Abdulrahim 2012). The marginalised group of
people are mostly found to be discriminated when it comes to health and social care services.
Cooperation can be considered as one of the fundamental processes of social life,
where two or more individuals work in groups to achieve a joint goal. Both the service users
and service providers of the Fleetwood hall home will have to work in cooperation to make a
sustainable environment in the hall home. Another factor is the accommodation.

10HEALTH CARE
Accommodation implies the way of the social adjustment (Bulmer 2015). The health care
workers have to work in harmony in social situations. New conditions might rise in a society.
It is the individuals who will have to make the adjustments to the new situations and resolve
the conflicts.
3.3. Inter-professional collaboration in health care occurs, when the health experts from
different fields work together for administering the highest quality of care to the patient.
Providing best care for the patient requires coordination and communication between all the
providers engaged in patient care. The collaborating professionals share common goals,
common mission and objectives (Kourkouta and Papathanasiou 2014).
In the Fleetwood hall home, it can be perceived that there are always not enough
staffs on the mental health department or the mental health assessment were mainly
completed in a generic way and thus it can estimated that the Hall home lacked a proper
mental assessment team.
The main aim of the inter-professional collaboration is to improve the access to care
and services for the residents of the Fleetwood hall home. With the increasing complexities
of the health care and the increase in the ageing population, it is necessary to exchange ideas,
skills and knowledge. Inter-professional collaboration helps to develop teamwork and allows
a wide range of treatment option to be available for the clients (Gittell, Godfrey and
Thistlethwaite 2013). Some of the members of the multidisciplinary team members involved
in patient care are psychotherapist for the dementia ward, the general practitioners, a
registered dieticians, primary care and community nurses. Apart from this, the managers
should always consult among themselves regarding the health and safety of the Fleetwood
hall home, regarding the flooring and the wiring of the hall home, the availability of the
assistive devices. Other advantages of inter-professional collaboration is that it helps to close

11HEALTH CARE
the communication gap, enables a comprehensive patient care, minimise the readmission
rates (Gittell, Godfrey and Thistlethwaite 2013). Working independently minimises the rates
of readmission and helps to promote a patient centred care.
Oishi and Murtagh (2014) stated, that the disadvantages of the inter-professional
collaboration can be conflict between the members, difficulty in organising meetings with the
different staff members of different professions. Conflicts might arise in the opinions
provided by the different staff members. Perception all the members of the multidisciplinary
team members might be different and thus can affect the patient care.
L.O. 4
4.1. Being a care worker I have realised that whatever be the role, it is always challenging as
well as rewarding. As a nurse I believe that my primary role is to advocate care for patient
belonging to any culture and ethnic origin.
Being a care workers, we are entitled to do several tasks like recording of the medical
history and symptoms, collaborating with the team to plan for the patient care, advocate for
the health and the wellbeing of the patient (Viruell-Fuentes, Miranda and Abdulrahim 2012).
Educating the nurses about the health, wellbeing and cleanliness, liaising the patients and
their families (Birken, Lee and Weiner 2012).
As a health and social care manager, I often have to provide support to an individual
with several aspects of their everyday living, including the personal, social and the emotional
care. It should be mentioned that the care homes are becoming more specialised, especially
for the patient suffering from dementia and those under the palliative care services. Being a
health care manager `I also have train and supervise the novice staffs. I am liable to ensure

12HEALTH CARE
that the home is functioning as per the regulations or any regulatory activities like personal
care and administration of the medicines are done within the regulatory guidelines. Just as the
patients, their families also require social support (Wong and Laschinger 2013). Being a
manager I ensure that their concerns are paid heed to. Residents of the care homes are mostly
elderly and any activities arranged should be based upon the needs of the elderly, as a care
manger I am liable to organise the activities for the residents and actively promote the
independence. I often have to liaise with and partner with the local community organisations.
Budget allocation and assessing the business process is an important role of the health care
managers where I have to use several technological advancements for improving the business
operations and the streamline processes. Working in a care settings accommodating the
mental health patients can be challenging (Evans et al. 2016). The care managers are
responsible for maintaining the ongoing tracking and documentation on the referrals for
promoting awareness in the team and ensuring patient safety. Being a health care manager I
am accountable to allocate competent staffs and any mistake on their part will also affect my
professional standard as well my career.
4.2. While introducing a new organisational policy, wit should be provided in a written form
and not verbally (Evans et al. 2014). As a care manager, I should educate all the staff
members about the policy and the procedures in a simple way. It should be mentioned that
the position of the care managers is a frontline leadership role that who are responsible for
assessing the needs of resident of the care home. A monthly audit is conducted to understand
the needs of the residents and the guidelines are planned as per the need assessment (Evans et
al. 2014). I have maintained a risk register to identify the risks like the rate of falls, adverse
drug reactions, allergic reactions and incidents of malpractice. A 24x7helpline number is
made available for the client’s families. Regular feedback are taken from the patients and the

13HEALTH CARE
families in order to investigate about any malpractices. The data of the audit are tallied with
the baseline data in order to understand the gaps in the health care services (Curran 2014). I
believe that rewards and recognition of the employees are necessary to maintain a smooth
workflow, hence suitable incentive schemes has to be introduced. As a care manager I made
it sure that the implemented guidelines comply with the legislation of the state.
4.3. Being a care manager, the success of my own care home would add a feather to my
professional career and would also fuel my aspiration to serve those who are in need. In order
to implement a successful policy guidelines I intend to remain updated with the state
legislation and should make sure that all the staffs abide by the guidelines. Again it is also
necessary to keep a track of the patient records, especially the electronic health record and
keep updated with the latest technologies, security measures, software and legislation
regarding patient privacy and confidentiality. Hence, I would ensure maximum use of
information technology in the documentation. I would ensure that the interest of the patients
are kept in the first place. The planning for the implementation of the planning procedure
should be made within a specific time frame.

14HEALTH CARE
References
Birken, S.A., Lee, S.Y.D. and Weiner, B.J., 2012. Uncovering middle managers' role in
healthcare innovation implementation. Implementation Science, 7(1), p.28.
Borson, S., Frank, L., Bayley, P.J., Boustani, M., Dean, M., Lin, P.J., McCarten, J.R., Morris,
J.C., Salmon, D.P., Schmitt, F.A. and Stefanacci, R.G., 2013. Improving dementia care: the
role of screening and detection of cognitive impairment. Alzheimer's & Dementia, 9(2),
pp.151-159.
Bulmer, M., 2015. The social basis of community care (routledge revivals). Routledge.
Cherry, K., 2012. Erikson's theory of psychosocial development psychosocial development in
infancy and early childhood. The New York Times Company. http://psychology. about.
com/od/psychosocialtheories/a/psychosocial. htm [26 May 2012].[Links].
Cherry, K., 2012. Social learning theory. Retrieved July, 2, p.2012.
Combes, C. and Azema, J., 2013. Clustering using principal component analysis applied to
autonomy–disability of elderly people. Decision Support Systems, 55(2), pp.578-586.
Curran, M.K., 2014. Examination of the teaching styles of nursing professional development
specialists, part I: Best practices in adult learning theory, curriculum development, and
knowledge transfer. The Journal of Continuing Education in Nursing, 45(5), pp.233-240.
Darling-Fisher, C.S., 2018. Application of the Modified Erikson Psychosocial Stage
Inventory: 25 Years in Review. Western journal of nursing research, p.0193945918770457.

15HEALTH CARE
Douglas, M.K., Rosenkoetter, M., Pacquiao, D.F., Callister, L.C., Hattar-Pollara, M.,
Lauderdale, J., Milstead, J., Nardi, D. and Purnell, L., 2014. Guidelines for implementing
culturally competent nursing care. Journal of Transcultural Nursing, 25(2), pp.109-121.
Evans, B.A., Snooks, H., Howson, H. and Davies, M., 2013. How hard can it be to include
research evidence and evaluation in local health policy implementation? Results from a
mixed methods study. Implementation Science, 8(1), p.17.
Ginter, P.M., Duncan, W.J. and Swayne, L.E., 2018. The strategic management of health
care organizations. John Wiley & Sons.
Gittell, J.H., Godfrey, M. and Thistlethwaite, J., 2013. Interprofessional collaborative practice
and relational coordination: improving healthcare through relationships.
Kemppainen, V., Tossavainen, K. and Turunen, H., 2013. Nurses' roles in health promotion
practice: an integrative review. Health Promotion International, 28(4), pp.490-501.
Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice. Materia
socio-medica, 26(1), p.65.
Mandal, J., Ponnambath, D.K. and Parija, S.C., 2016. Utilitarian and deontological ethics in
medicine. Tropical parasitology, 6(1), p.5.
Mitchell, P. and Golden, R., 2012. Core principles & values of effective team-based health
care. National Academy of Sciences.
Morgan, S. and Yoder, L.H., 2012. A concept analysis of person-centered care. Journal of
holistic nursing, 30(1), pp.6-15.

16HEALTH CARE
Oishi, A. and Murtagh, F.E., 2014. The challenges of uncertainty and interprofessional
collaboration in palliative care for non-cancer patients in the community: a systematic review
of views from patients, carers and health-care professionals. Palliative medicine, 28(9),
pp.1081-1098.
Tappen, R.M., 2016. Advanced nursing research: From theory to practice. Jones & Bartlett
Publishers.
Viruell-Fuentes, E.A., Miranda, P.Y. and Abdulrahim, S., 2012. More than culture: structural
racism, intersectionality theory, and immigrant health. Social science & medicine, 75(12),
pp.2099-2106.
Wong, C.A. and Laschinger, H.K., 2013. Authentic leadership, performance, and job
satisfaction: the mediating role of empowerment. Journal of advanced nursing, 69(4),
pp.947-959.