Leadership and Change for Service: Case Study of Care Home for Elderly People

This report presents a critical analysis of the problems faced by the healthcare for elderly people during shift changes and provides efficient strategies to eliminate the identified issues and provide better services. It includes a SWOT and PESTEL analysis, proposal for implementation and evaluation, and leadership and management theory.

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Leadership and Change for Service
Case Study: ‘Care Home for Elderly People’
Name of the Student
Name of the University
Author Note

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Table of Contents
Introduction......................................................................................................................................2
My Reflection on the Projects Problems or Issues......................................................................2
Explanation of the Key Problems....................................................................................................3
Existing Ways of Care Delivery..................................................................................................5
Problem Solving Attempts...........................................................................................................5
Critical Analysis of Required Changes............................................................................................6
Analysis of Problems or Issues....................................................................................................7
Leadership and Management Theory..........................................................................................8
SWOT Analysis...........................................................................................................................9
PESTEL Analysis......................................................................................................................11
Proposal for Implementation and Evaluation................................................................................12
Implementation..........................................................................................................................12
Gantt chart.............................................................................................................................12
Evaluation..................................................................................................................................15
Questionnaires.......................................................................................................................15
Conclusion.....................................................................................................................................16
References......................................................................................................................................17
Appendix........................................................................................................................................20

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Introduction
Health care industry is one of the most beneficial sector for the community as the rate of
the health care needs to be enhanced in manner to keep the society healthy and assuring that
every individual of the community is getting proper benefits. Every individual of the society has
the right to be healthy and avail all the medical or healthcare facilities those are necessary for
their well - being. Health Care for Elderly Home is one of the attempts of the government or
private organization to contribute in the well - being of elder people and make sure that they
have been provided at the same place as that of other age groups. It is identified that there are
many health care for elder people in UK however; most of them are not capable of providing the
highest standard of the services to the elder people. This report will demonstrate the respective
problems those are leading to the inefficient management and service delivery within this sector.
My Reflection on the Projects Problems or Issues
I identified that this topic is vital in manner to respect the elder people and make sure that
the generation that paved this life for us avails all the services those they deserve. The most
concerning sectors those could be considered as the most influencing factors for this sector
include the following issues:
1. Bad report writing is one of the issues related to problems associated while employees
changes their shift at the night
2. Unavailability of the unit manager during night shift
3. Lack of communication among the staffs during shift change or between different shifts
4. Lack in number of staffs during night shift

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The research will be driven considering the problems being faced in the healthcare for
elder people during the shift changes and make sure that we reaches at the conclusion that will be
capable of eliminating the identified issues and providing efficient strategies. This report will
present a critical analysis on the same topic and assure that the elder people at the health care
will be having proper place in the society and avail the services those are their right.
Explanation of the Key Problems
The elder people always need proper care as their nature is sensitive and nurses should
take care of their well - being and living in manner to assure that the health care services being
provided to them is of high standard. These problems are capable of influencing the efficiencies
of the health care and being an obstacle in providing better services to the elder people (Cameron
and Green 2015). During the shift changing, the staffs and employees does not communicate
efficiently and that lead to certain problems and causing disturbance in the management and
hence, the services being delivered to them. Following are the three major problem sections
those are the vital obstacles in allowing the healthcare to care for the elder people:
1. Bad report writing: Elder care home needs to take care of the elder people for 24 * 7
hours and hence, the report of the improvement and ongoing medical care is necessary to
be more effective and efficient. This is the only way that the employees coming in the
next phase is capable of providing better care to them and assuring that the current
development will be manipulated as per the ongoing healthcare (Kendrick 2015). This is
one of the lagging factors that can ultimately lead to the improper and ineffective caring
for the elder people and hence, it is an obvious factor that the report presentation should

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contain vital information related to the ongoing medical and patient care and allowing the
next employees to manage the care accordingly.
2. Unavailability of the unit manager during night shift: It can be observed that during the
shift change, the staffs do not accomplish their sector of in an efficient and effective
manner and that can be a trouble in delivering better services (Doppelt 2017). Despite of
these factors, there is not any manager to manage them and assign those proper roles and
responsibilities those could lead to accomplishment of their individual sector of work.
3. Lack of communication among the staffs during shift change or between different shifts:
Communication is the greatest way of assuring that the elder people are being taken care
for good and thus, assuring that every member in the ‘health care for elder people’ are
being treated in effective way. The first mentioned problem is related to the report and it
is a medium of communication between the staffs however; the entire system lacks in
communication and thus, managing the entire environment can be difficult for the
management. Communication offers the employees to understand each other’s situation
and make them understand their perspective and progress accordingly within the same
environment (Hilson and Murray 2017). It is necessary for proper health care that every
employee has the better relation with each other in manner to manage and execute the
operations if anyone of them is unavailable while doing their jobs.
4. Lack in number of staffs during night shift: Most of the organization does not care about
the elder people or patients during night shift and that could lead to several issues for the
patients or elders who are in need during that shift (Hayes 2018). Availability of the
nurses during night shift is of same importance than that the need of day shift as the elder
people need care for 24*7.

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Existing Ways of Care Delivery
The existing ways of patient care focuses on the availability of the resources rather than
focusing on the better management of the available and allocated resources. The stated problems
are more or less exist in all the ‘health care for elder’, as focus is being provided to the resources
not on their management in an efficient and effective manner (Thomas 2015). The management
of the resources can be defined as the effective and efficient application of the available
resources and keep them available throughout the ongoing operational activity (Kerzner aand
Kerzner 2017). Patient care is one of the sensitive sector within the health cares and management
is one of the crucial factor for assuring that the cares function in effective and efficient manner.
Problem Solving Attempts
The primary focus should be made on the management of the resources those are
available and introducing or collaborating the new resources those are helpful in assuring that the
requirements of the healthcare are being successfully fulfilled and the elder people are
effectively being served by the nurses. There should be a template available for documenting the
reports and assuring that the nurse record the proper and accurate data related to the development
of elder people care (Kerzner 2017). The attempt can be driven through introducing a special unit
manager for managing the resources during night shift and allocating proper job responses for
them and assuring that every sector has certain qualified human resource.

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Critical Analysis of Required Changes
Figure 1: Critical path analysis
(Source: Created by Author)

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The activities those are necessary for the delivery of this project has been demonstrated in
the above picture including the relation between the early start and early finish, and late start and
late finish. The activities other than blue are the vital and critical activities those need to
accomplish within the expected timeline and budget with an assurance that the further activities
can be manipulated, if the determined project needs to be implemented in an efficient and
effective manner (Kerzner 2018). The relationship between the activities has been represented in
the form of the arrows and all the activities those are not capable of influencing the entire project
has been represented in the above figure. In manner to accomplish the problem solving for the
employees communication in the healthcare for elder people can be taken care, if the above
mentioned activities is accomplished in an efficient manner (Verzuh 2015). The timeline of the
critical activities should not be altered in manner to develop the sophisticated model within the
allocated deadline.
Analysis of Problems or Issues
The problems stated above have been already raised as a concern for many of the writers
and they show their interest in many of their research papers and articles. Ginter, Duncan and
Swayne (2018) stated that shift changing within the health care should be managed in an
efficient and effective manner and it plays very vital role in executing the system for developing
the necessary output and production. Shift change lead towards many crucial issues those need
proper consideration while leading towards a sophisticated model of care for the health care for
elder people. Northouse (2018) claimed that proper and effective integration of the leadership
and management is one of the best appropriate solution for the health care to provide best
services to their patients. Since most of the health care has less number of employees, the

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strength does not allow to take care of the elder people with same efficiency as that is done
during the morning shift.
Leadership and Management Theory
Better and relevant leadership allows the team members or the group of the employees
focuses on the same strategy and delivers the necessary objectives of the entire project or
operational activities. Busse, Aboneh and Tefera (2014) states that leadership is a trait in which
an individual motivate or manipulates the individual towards the strategy and path set by the
leader and make them to move on the same track that lead the organization towards the success
and better outputs. Shift change needs proper and effective management strategies those can
bound the employees to be more conscious and attentive towards accomplishing their sector of
work. Drucker (2017) expressed that role of a team plays very crucial role for ant organization in
manner to manage their respective consumers or customers. Similar condition can related to the
health care of the elder people and the entire team should contribute in the proper and effective
care for them and assuring that best care is being provided to them. Management of the
employees while shift change requires proper and effective balance in between the employees
and the patients, that can only be accomplished, if the individual assigned as the leader has the
ability of proper management (Stanphone and Lancaster 2015). Communication has been
claimed as one of the vital lagging factors in the above report and it is an obvious factor that the
effective leadership and management strategies will have certain plans for communication and
thus, every employee would be allowed to communicate in an effective and efficient manner.
There are certain policies developed and imposed by the healthcare those have been
always executed through taking the initials of the individuals over the developed policies. These
policies provide the health cares with loop holes in manner to cope up with certain legal issues

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however; these are the only strategies those assure that the developed system is capable of
providing all the necessary benefits those have been promised while patients are introduced to
the health care. The above mentioned issues are directly capable of dis-balancing the service and
products to the consumers in an efficient and effective manner and hence, these problems need to
be eliminated to the extent level (D’Andreamatteo et al. 2015). The community does care about
the elder people and it is the need for the community to be better through better caring of the
elder persons and providing them better and enhanced service those are their right. Elder people
are the part of the community and hence, they should be treated as an important factor because
they had already made the contribution in the development of the society in which the present
generation is living. Their knowledge and experience can be utilized for the implementation of
the strategies those are the best option for the present development and hence, they should
always be a greater concern for the delivery of the better community or society. Leadership and
management strategies could assure the efficient and effective care of the elder people within the
health care (Borkowski 2015). The shift change issues and problems mentioned above can be
solved through the effective and efficient leadership and management strategies for the
employees working in the health care.
SWOT Analysis
Strengths
Proper report documentation will be helpful
for the employees from next shift to better
understand the current growth and medication
of the elder people.
Enrollment or recruitment of a unit manager
Weakness
It will no doubt increase the budget or cost of
the health care than it was estimated before
Increase in number of staff could lead to
ineffective management of their roles and
responsibilities within the entire health care

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to manage the operational activities within the
health care for elder people as it will be
helpful in assuring that the shift changing and
roles of the employees are same as that of the
applied roles and responsibilities in the
system (Marmor 2017).
Communication strategies should must be
enhanced or manipulated in manner to make
sure that every employee is having a better
relation with other employee and the activities
are being delivered in an efficient and
effective manner.
Increasing the number of staffs can be a better
approach in assuring that the elder people are
having proper and effective care and best look
after.
system.
Opportunities
It can enhance the number of elder people
agree for availing the services being
introduced by the health cares (Scott et al.
2018).
It can provide option for the elder people to
have a society where they can have the
Threats
This could lead to rebel among the other
employees and they could stand against the
implementation of these strategies (Dees
2017).

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community of people with same age and
thinking and avail their rights.
PESTEL Analysis
Political: The UK government has always supported the health care for elder people and
hence, the implementation of the strategies those could possibly enhance the care for the elder
people will be smoothly imposed within the existing systems of the health care. The proposed
modifications will allow the employees to be more serious about their jobs under proper and
effective leadership and management and thus, accomplish the operational activities.
Economic: The enhancement in the health care will no doubt make feel the elder people
that they are the part of the community and the society could utilize their knowledge and
experience for future (Cooke and Bartram 2015). The employees will contribute in the
enhancement of the community.
Social: The proposed modifications will be beneficial for the society as the elder people
will be provided with better care and certain position will be provided to them.
Technological: Proper management and leadership can only be accomplished through the
application of latest project management tools and techniques and thus, incorporation of
technologies will alternatively result in better and effective communication among the
employees and the executives (Ignatavicius and Wokman 2015).
Environmental: The current situation has certain ethical issues for both the elder people
and the management managing the existing system and care for the elder people. There is always
certain ethical issue associated with every course of action however, proper consideration every

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member’s perspective will be helpful in limiting the ethical issues and taking best course of
action (Woods 2017).
Legal: Health and safety is one of the legal factors associated with citizen of UK and
here, the topic about the health care and so it became obvious to ultimately provide better and
effective heath care for the elder people.
Proposal for Implementation and Evaluation
Implementation
The proposed project is all about proposing information related to the problems being
faced by the elder people and the employees while changing their shift at night. The employees
need to take care of their sector of work and for that effective leadership is the most appropriate
and effective strategy. The implementation will need to be planned in an effective manner and
planning should be effective enough to be applicable and suitable for every stakeholders (Hunter
et al. 2014). These strategies will need to follow the activities in sequential manner as stated in
the following table. There are three phases that includes planning, execution, and closure and all
the activities need to be accomplished within the specified time in manner to close the project
within the estimated timeline.
Gantt chart
Task Name Duration Start Finish
changes implementation 37 days Mon 7/30/18 Tue 9/18/18
Phase 1: Planning 13 days Mon 7/30/18 Wed 8/15/18
Identification of the issues 3 days Mon 7/30/18 Wed 8/1/18
Analysing the current environment 3 days Thu 8/2/18 Mon 8/6/18
Questioning Nurses 5 days Thu 8/2/18 Wed 8/8/18

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Interviewing elder people 5 days Thu 8/9/18 Wed 8/15/18
Preparing report 4 days Thu 8/9/18 Tue 8/14/18
Phase 2: Execution 18 days Wed 8/15/18 Fri 9/7/18
Staff meeting 7 days Wed 8/15/18 Thu 8/23/18
Meeting with unit manager 2 days Fri 8/24/18 Mon 8/27/18
Informing suggested changes 4 days Fri 8/24/18 Wed 8/29/18
Executing training program 7 days Thu 8/30/18 Fri 9/7/18
Phase 3: Closure 7 days Mon 9/10/18 Tue 9/18/18
Analysing the effectiveness of implemented
strategies 3 days Mon 9/10/18 Wed 9/12/18
Interviewing elder people 4 days Mon 9/10/18 Thu 9/13/18
Project documentation 3 days Fri 9/14/18 Tue 9/18/18
Figure 2: Gantt Chart
(Source: Created by Author)

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Evaluation
A survey has been distributed to the stakeholders associated with the same sector and
their results have been analyzed in the form of the chart and pies as demonstrated in the appendix
section.
Questionnaires
Following questions were distributed among the general people and to the employees of a
health care for elder people and their information were collected and analyzed in manner to
determine the thoughts of the individuals in this perspective.
 Please, let us know about your gender
 Please, let us know about your age group
 Due to shift changing at night, elder people face many problems
 There is not any manager available during shift changing
 Report writing is one of the problem during shift change
 Documentation of residents is another problem
 Communication is one of the lagging factor in providing better services
 Better communication can solve issues
 Availability of the manager during night shift can be one of solving factors
The responses and data analysis has been presented in the appendix section of this report that
suggests that the research was driven in right path and the issues were of same concern for many
of the individuals. The communication, and effective leadership and management has been
proposed as the most effective solution of the problems raised during the shift changing of the
employees at night. The questionnaire was distributed among eighty individuals however, 53
responses were recorded for the delivery of this research.

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Root Cause Analysis
The primary cause of the lagging factors identified due to the ineffective and improper
communication between the employees during shift changes. Four types of communication can
be determined those are being utilized and applicable for the delivery of the communication
strategies. The communication ways are verbal (face to face communications), verbal (through
telephone) communication and written (emails) or technological/technical (electronic diaries,
voice recorders) communication. The care home in which the research was driven had 25
residents per unit that was being managed by two care assistants and a qualified nurse at the
night shift. There are 2 residents, 4-5 care assistants, 1 qualified nurse, and 1 hostess responsible
for physical activity for residents during day shift. A quantitative approach can be driven based
on the time being provided for the communication with the residents as follows:
Among twenty five residents, two of the residents need seven minutes of communication
for the better care, and twenty three residents have normal span and will need 45 seconds to
communicate and hence the following calculation can be delivered:
(2*7) + (23*0.6) minutes = 27.8 minutes = 30 minutes (approximately)
After looking into the different shifts, it was identified that there are two shifts starting
from 8:00 a.m. to 8:00 p.m. and the next shift starts at 8:00 p.m. to 8:00 a.m. without and time
lagging for the communication. The management should consider it as a concerning sector
towards the delivery of the care for them as the staffs of the two different shifts should must have
some time to communicate about the on-going growth and development activities for the resident
cares. Handover the report to the staff of other shift to understand all the properties need to
verbally communicate and so if the management decreases the 15 minutes from both the shifts.

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The first shift should end at 7:45 p.m. and the next shift should start from 8:15 p.m. and thus, it
will allow thirty minutes for every staff to communicate about the patients.
This will also be cost effective for the care home as they could now pay for the 11 hours
forty five minutes for every staff and hence the saved money for a year can be calculated as:
£5 per hour is the current salary and hence the sorted timing is:
(15 minutes = 0.25 hrs) * 365 days * 25 staffs = 2281.25 hrs saved timing and the management
will have not to bear the load of £5 * 2281.25 hrs = £ 11406.25
Among the different ways of the communication, the best communicating medium is the
verbal (face to face communication) and following SWOT analysis is being driven on the verbal
communication:
Strength
It will allow better communication medium
and understand the patient needs and
treatments.
Better care for elder people
Efficient and effective care
Cost effective approach
Weakness
Body language can be hard to understand
No record
No memory storage other than individual’s
brain
Opportunity
Enhance the individual care of residents
Allow time to make new strategies
Can lead towards best caring centers
Threats
No record
Body language
Proper training

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Conclusion
Based on the above report it can be concluded that the above mentioned problems have
been successfully analyzed in manner to proceed the research towards finding the solution of the
identified problems. The identified problems are capable of influencing the entire care system for
elders in negative manner and it is a vital factor to manage the employees while changing their
shift at night. This report presents the literature related to the problems and issues faced by the
employees during changing their shifts. Thereafter, literature has been presented with a Critical
Path Management method for highlighting the crucial activities those are necessary for the
proposition of an effective and efficient solution that can manage the employees while changing
their shifts. A survey has been also proposed in this report expressing the point of views for
different individuals who are associated with the same sector and a quantitative result has been
expressed. The most concerning problems associated during shift change were the poor
documentation of the report related to the growth and development of the elder people in the
health care, poor communication between the employees of different shifts, unavailability of the
unit manager during night shift, less number of staffs as that compared to the day shift. The
proposed solution for these problems are the allotment of an unit manager who is capable of
handling all the operational activities at that shift, proper and effective leadership and
management, better communication, enhancing the number of staffs.

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References
Barr, J. and Dowding, L., 2015. Leadership in health care. Sage.
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Busse, H., Aboneh, E.A. and Tefera, G., 2014. Learning from developing countries in
strengthening health systems: an evaluation of personal and professional impact among global
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Cameron, E. and Green, M., 2015. Making sense of change management: A complete guide to
the models, tools and techniques of organizational change. Kogan Page Publishers.
Cooke, F.L. and Bartram, T., 2015. Guest editors’ introduction: human resource management in
health care and elderly care: current challenges and toward a research agenda. Human Resource
Management, 54(5), pp.711-735.
D’Andreamatteo, A., Ianni, L., Lega, F. and Sargiacomo, M., 2015. Lean in healthcare: A
comprehensive review. Health Policy, 119(9), pp.1197-1209.
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Doppelt, B., 2017. Leading change toward sustainability: A change-management guide for
business, government and civil society. Routledge.
Drucker, P., 2017. The age of discontinuity: Guidelines to our changing society. Routledge.

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Ginter, P.M., Duncan, W.J. and Swayne, L.E., 2018. The strategic management of health care
organizations. John Wiley & Sons.
Hayes, J., 2018. The theory and practice of change management.
Hillson, D. and Murray-Webster, R., 2017. Understanding and managing risk attitude.
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Centered Collaborative Care. Elsevier Health Sciences.
Kendrick, T., 2015. Identifying and managing project risk: essential tools for failure-proofing
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scheduling, and controlling. John Wiley & Sons.
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Kerzner, H., 2018. Project management best practices: Achieving global excellence. John Wiley
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Marmor, T.R., 2017. The politics of Medicare. Routledge.
Northouse, P.G., 2018. Leadership: Theory and practice. Sage publications.

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Pollitt, C. and Bouckaert, G., 2017. Public management reform: a comparative analysis-into the
age of austerity. Oxford University Press.
Scott, T., Mannion, R., Davies, H. and Marshall, M., 2018. Healthcare performance and
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CRC Press.

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Appendix
 Please, let us know about your gender
 Please, let us know about your age group
 Due to shift changing at night, elder people face many problems

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 There is not any manager available during shift changing
 Report writing is one of the problem during shift change

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 Documentation of residents is another problem
 Communication is one of the lagging factor in providing better services
 Better communication can solve issues

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 Availability of the manager during night shift can be one of solving factors
Survey Data
Gantt chart MS project file
Untitled form -
Google Forms.pdf
Project1.mpp