Management of Domiciliary Services

This assignment focuses on the management of domiciliary services, including the impact of the legislative framework, evidence-based research, and organizational protocols. It explores the influence of person-centered practice, ethical dilemmas, and conflicts experienced by managers and practitioners. The assignment also explains the systems used to calculate and justify charges for domiciliary care and the challenges associated with addressing day-to-day changes and emergencies.

Manage Domiciliary Services

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
1.1 Evaluate how the current legislative framework, evidence based research and
organisational protocols impact on the management of domiciliary services........................1
1.2 Explain how person centred practice influences the management of domiciliary services.
................................................................................................................................................2
1.3 Analyse ethical dilemmas and conflicts experienced by managers and practitioners’
domiciliary services................................................................................................................3
2.5 Explain systems that calculate and justify charges for domiciliary care..........................4
4.3 Explain the importance of supporting practitioners to challenge systems and ways of
working...................................................................................................................................5
5.1 Explain the challenges associated with addressing day to day changes and emergencies in
domiciliary services................................................................................................................6
6.6 Explain the actions should be taken when practitioners do not comply with agreed ways of
working...................................................................................................................................7
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9

INTRODUCTION
Domiciliary services refers to care facilities which are provided to people live in their homes but
requires extra help with activities like household tasks, personal care and other activities. It
includes the care practitioners who visit home of patients and take care of them and monitor their
condition all the time (Zalazar and et. al., 2019). It is an important part of health & social care
services which provide support to sick people living in their homes to live with independence
and better quality of life. In context of this assignment, it will focus on legislation, evidence
based practice and persona centred care. It will also include e ethical dilemmas and effective
systems to evaluate charges of domiciliary facilities. The importance of supporting practitioners
and challenges related with emergency situations are given below.
MAIN BODY
1.1 Evaluate how the current legislative framework, evidence based research and organisational
protocols impact on the management of domiciliary services.
The current legislative framework plays an important role in terms of delivering domiciliary
services to needy people in effective manner. It includes different kinds of legal regulations and
acts which must be followed by every domiciliary care providers while dealing with sick
individuals. However, it consist Equality Act 2010, Data protection act 2014, Health & social
care act 2012, The care act 2012 and many more. Meanwhile, current equality act direct
professionals to never become partial with any one of patient and equally deliver proper care and
treatment in context of domiciliary care settings. It is required for these practitioners to take
responsibility of situation happen with patient whether it is positive or negative according to the
care act (Brown, 2017). In addition to this, health & social care act directs care staff to utilise
appropriate structure of their organisations and other resources in order to render correct medical
facilities for wellness of an individual. Moreover, the data protection act provide instructions to
professionals that they should not disclose patient information with other people and that data
can be only accessed by associated professionals in care of a person.
Evidence based researches are helpful to gain effective treatment methods and medications with
their evidences so that they can be used securely to make patient disease free. It is necessary for
medical professional working in domiciliary care to carry out clinical practices and provide
medications which has evidence. However, it include legal regulation for care professionals that
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they should consider treatment and medicines which clinically approved by authorized
organisation. They only approve medications and appropriate therapies which are proved by
medical investigations that they are suitable to use for making patient healthy.
On the other hand, organisational protocols consists number of clinical policies and regulations
which are made by management of particular healthcare organisation. It includes following
ethics and never misbehaving with female colleagues & patients or other misconduct. However,
it is necessary for care professionals to remain more professionals while providing care to an
individual at their home (Kubalčíková and Havlíková, 2016). It is required to avoid getting in
personal relation with patient and following ethical and legislations in appropriate manner.
However, it is essential to stay out from home sharing and take payment for support & care
provided to patient at home. Moreover, professionals should create mutual understanding with
patient and deliver effective care for their wellbeing in domiciliary care settings.
1.2 Explain how person centred practice influences the management of domiciliary services.
Person centred care can be defined as an appropriate approach in which care plan will be formed
by considering actual needs of an individual. It includes focusing on considering treatment
methods and techniques which are more comfortable from patient view point and they can be
used clinically for better health of them. Basically, care professionals working in domiciliary
settings are required to use person centred care because it is beneficial in improve respective
patient outcomes. In addition to this, person centred care is known to be an important and
beneficial approach because patient should put in centre to make decision of treatment process to
be followed for their wellness. Meanwhile, in this approach, professionals should make sure that
patient actively participate in preparation of their care plan and they can make choice of taking
treatment which is suitable for them (Yao and et. al., 2017). Moreover, practitioners working in
domiciliary care should follow person centred values like individuality, rights, privacy, choice,
independence, dignity, respect and partnership. It will provide support to provide accurate care
services which helps to eliminate threat of occurring complications.
The care professionals working in domiciliary care settings are required to follow approach of
person centred care because it helps them to deliver services properly. It includes the important
factor that must be considered by care providers are to pay respect and dignity to patient.
However, it has been analysed that they should make effective communication with patient
which helps to develop healthy relations which facilitate to make correct decision of providing
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better health facilities. It will provide support to make people disease free and support them in
their daily living to facilitate better quality of life as well as independence respectively.
However, person centred care include that professionals should follow ethics and provide
information to patient about their treatment process and its respective outcomes. Moreover, it is
necessary for domiciliary care professionals to maintain privacy and provide in equal manner to
every patient to make them diseases free.
1.3 Analyse ethical dilemmas and conflicts experienced by managers and practitioners’
domiciliary services.
Ethical principles or factors are important in healthcare sector and professionals should follow
ethics while dealing with patients. It is favourable to direct efforts of domiciliary practitioners in
correct direction which facilitate to deliver appropriate care to needy people. Basically, ethical
principles include various factors which have their specific role to deliver accurate care for
welfare of an individual (Frankova, 2018). However, it has been analysed that ethical dilemmas
and conflicts may occurs among mangers and practitioners working in domiciliary services.
Ethical dilemmas in domiciliary care
Patient confidentiality: The factor of maintain confidentiality of patient is important
because a minor medical issue may develop a major social problem for them. They may
suffer from their entire life regarding this issue in society. However, the relevant ethical
dilemma is responsible for hurting an individual as well as develops legal as well as
ethical consequences for domiciliary care workers. The professionals should follow
guidelines provided by HIPPA (Health Insurance Portability and Accounting Act) to
release patient data.
Patient relationships: This involves the criterion of remain profession to provide
domiciliary care services by making healthy relation with a person. It is necessary to
develop mutual understanding and fulfil care needs of an individual for their wellbeing.
However, it involves the ethical dilemma when professional enter in personal relations
with patients or abuse or misbehave during care process (Sullivan and Skelcher, 2017).
Violating this ethical principles result into cancellation of license or being forbidden to
deliver any kind of health facilities in future.
Malpractice & negligence: The policy of avoiding malpractice and negligence is present
in domiciliary care settings. It is necessary for professionals to secure patients from any
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kind of malpractice and neglect but some of professionals forget to do so. This involves
ethical dilemma situation when patient get harmed by defective medical equipment or
placed in danger due to medical errors.
Conflicts in domiciliary care
Communication problem: The miscommunication or limited communication can develop
conflicts among manager and practitioners in domiciliary care because effective
communication is must to make appropriate decision of treatment (Hadley and Hatch,
2018).
Role disputes: This involves the situation when mangers allotted clinical task about
which domiciliary care practitioner do not have any knowledge then role dispute occurs.
It is necessary for manger to first provide training and allocate new tasks for practitioner
avid such conflict.
Lack of professional conduct: The lack of professional conduct create conflicts among
manger and practitioners because professional conduct must be followed to provide better
quality of care in domiciliary care settings.
2.5 Explain systems that calculate and justify charges for domiciliary care.
The calculation of charges related to domiciliary care is required to accurate as well as justified
to gain satisfaction of patient. It includes the criterion of calculating electronically the charge of
care services provided to an individual with justification. However, the system used for
calculation and justification of charges for domiciliary care is ‘Charge master’ which is also
known as charge description master. It can be considered as effective system which is a
comprehensive listing of items billable to a hospital patient or patient health insurance provider.
In addition to this, this system is much effective as well as efficient in order to make accurate
calculations of delivered services and care which are justified (Evans, 2016). It is very important
for care professionals to justify the paid amount by patient in terms of care facilities they have
received. Moreover, there are number of benefits which can be received by using charge master
system in which some of them are given here.
 Initially, it is beneficial as it is responsible to allow differentiation by quality as well as
cost of care which is important in domiciliary care settings.
 Secondly, it is favourable in terms of increasing public awareness and accountability for
charges in domiciliary care.
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 Thirdly, it is a long term opportunity to present higher value of imaging services.
 However, it is helpful to revenue cycle management in every healthcare organisation
operating with domiciliary care.
The components of charge master for domiciliary service:
 It includes the item number of services assigns to the line item unique to a particular
facility.
 It consist that present procedural terminology code or coding by standard procedure
coding system of healthcare (Scapinello and et. al., 2016).
 It is required that description of an item to translate the code for a short text description,
revenue code.
 The charge of every specific facility.
 It involves the department designation in numeric form.
 Ledger number for accounting.
4.3 Explain the importance of supporting practitioners to challenge systems and ways of
working.
The opportunity to practitioners in order to challenge the systems is important to make further
improvements. It includes evaluate different types of choices which are effective to make
specific healthcare system more efficient to deliver appropriate medical services. However,
medical professionals work with respective equipment and product to deal with various patients
having severe diseases then they have better knowledge about best clinical process to be used in
specific area. It has been analysed that care professionals can suggest better ways to work more
effectively and deliver best quality of facilities to make an individual healthy. Meanwhile, it is
important to support practitioners to challenge systems and ways of working because it is
suitable to evaluate current problems as well as threats of current healthcare system which should
be focussed to be overcome with them. They are capable to provide appropriate performing
issues along with better suggestions to solve them in which some of them are given below.
 Ineffective management: The management should be appropriate in order to manage all
the clinical tasks and provide services all the desired patients because any tasks cannot be
delayed in healthcare. It includes the problem that every individual staff has extra work
load due to which they are not able to fulfil their responsibilities effectively. However,
this problem can be solved by managing tasks like similar tasks and nearby areas of
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hospital should be allocated to specific team of nursing staff then visiting too far
departments can be avoided and save time to deliver proper services.
 Lack of latest technological equipment: This involves the problem that hospital has old
version of equipment and some of them are too old due to which new technological
equipment are required to reduce medical errors or drug errors. Lack of latest technology
is responsible for developing several problems like clinical errors, injuries to staff, patient
problem etc. This can be solved by applying strategy to put some of equipment for
maintenance and replace the tools which are very old.
 Lack of training and learning: The healthcare organisation provide training to only new
staff or fresher but never conduct learning sessions for currently doing their work. It can
be solved by organising training session separately for staff as per new health issues,
technologies and other aspects to increase their skills as well as knowledge level.
5.1 Explain the challenges associated with addressing day to day changes and emergencies in
domiciliary services.
The day to day changes and emergencies are responsible for developing different types of
challenges for practitioners in domiciliary services. It is necessary for care professionals evaluate
these problems in order to remain prepare to deal with such situations in proper manner.
However, some of these challenges are given below.
 It includes the realistic preparation which becomes a challenge for domiciliary care
practitioners as different things are to be packed like food items, water, medicines & first
aid kit, sanitary supplies, communication devices etc. It is difficult to remember in
emergency situation to pack all the necessary things and if single one get missed then it
will create a problem for a professional (Pollock and et. al., 2020). However, it has been
analysed that keeping list of essential items in domiciliary care is helpful to address the
problem of forgetting things to be packed. Moreover, permanent kit can be packed in free
time to deal with emergency situation in domiciliary care.
 The emergency situations have major challenge that is loss of power because contingency
requires immediate decision and action but lack of power restricts professional take
decision. It is require to provide some of authority to junior employees so that they can
make immediate decision of care in contingency situations because delayed services may
leads to occurrence of complications for an individual. Meanwhile, it is helpful for
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increasing efficiency and skill of staff along with delivering appropriate care facilities to
an individual for their wellness. Through this strategy, the challenge of loss of power can
be solved for improving care facility level and patient outcomes.
 The sickness of domiciliary care practitioners is a huge challenge because if a person is
not completely well then it is not possible to provide care to others. It is necessary for
hospital management to focus on health condition of nursing staff which facilitate to
ensure about delivery of better quality of facilities. However, it has been analysed that
providing instructions and intake of food items during working hours are helpful improve
eating patterns and healthy lifestyle among medical practitioners. Moreover, it will
provide support to address the challenge of sickness among domiciliary care
professionals.
6.6 Explain the actions should be taken when practitioners do not comply with agreed ways of
working.
The agreed ways of working should be applied by care practitioners properly to deliver effective
medical facilities. It is necessary to gain knowledge about best agreed ways and follow them
while dealing with sick people. However, it has been analysed that sometimes professionals do
not comply with agreed ways of working then specific actions must be taken by hospital
management which are mentioned here.
o It includes establishing policies of organisation by considering agreed ways of working
that must be followed by every individual.
o It is required to mention termination or punishment criterion for medical staff who does
not comply agreed ways of working.
o The action involves applying policy of deducting salary amount of staff on daily basis
that will not follow desired clinical procedures.
o It includes making policy of cancelling license of medical professional in specific
condition if their misconduct will develop complications for patient or death.
For example, Staff supervision is effective by providing suitable working shifts in my own
practices which is helpful for them to maintain the level of performance to deliver appropriate
care facilities for wellbeing of patients.
For instance, the management of my working practices includes working in flexible in different
care units and give opportunity to staff for performing in multi-disciplinary care. It is favourable
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to improve skills and knowledge level along with increasing their clinical efficiency for
improving better quality of facilities on domiciliary care settings.
For example, performance management is effective in my organisation which is helpful for staff
to overcome with their regular fatigue and stress to get back to work with proper energy. It is
helpful for maintaining health of employees along with delivering effective care services
properly.
CONCLUSION
From the above report, it has been concluded that domiciliary services can be defined as care
facilities which are provided to people live in their homes but requires extra help with activities.
It includes the legislation like equality act & data protection act and ethics like autonomy,
informed consent etc. meanwhile, it involves ethical dilemmas such as patient confidentiality,
patient relationships and malpractice & negligence along with conflicts like communication
problem, role disputes & lack of professional conduct. Moreover, it consist the important
practitioners to challenge health system for developing issues like ineffective management, lack
of latest technological equipment and lack of training and learning to solve them.
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REFERENCES
Books and journals
Zalazar, V. and et. al., 2019, July. Acceptability of HIV and syphilis domiciliary testing among
transgender women in Buenos Aires, Argentina. In JOURNAL OF THE
INTERNATIONAL AIDS SOCIETY (Vol. 22, pp. 26-27). THE ATRIUM, SOUTHERN
GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND: JOHN WILEY & SONS
LTD.
Brown, L., 2017. Community physiotherapy service: an evidence based proposal to identify and
manage community dwelling adults with or at risk of developing impaired
cough (Doctoral dissertation, University of Cumbria).
Kubalčíková, K. and Havlíková, J., 2016. Current developments in social care services for older
adults in the Czech Republic: Trends towards deinstitutionalization and
marketization. Journal of Social Service Research, 42(2), pp.180-198.
Yao, N. and et. al., 2017. Increasing role of nurse practitioners in house call programs. Journal of
the American Geriatrics Society, 65(4), pp.847-852.
Frankova, H., 2018. State of adult social care services. Practice Management, 28(3), pp.36-40.
Sullivan, H. and Skelcher, C., 2017. Working across boundaries: collaboration in public
services. Macmillan International Higher Education.
Hadley, R. and Hatch, S., 2018. Social welfare and the failure of the state: Centralised social
services and participatory alternatives (Vol. 6). Routledge.
Evans, T., 2016. Professional discretion in welfare services: Beyond street-level bureaucracy.
Routledge.
Scapinello, M.P. and et. al., 2016. Predictors of emergency department referral in patients using
out-of-hours primary care services. Health Policy, 120(9), pp.1001-1007.
Pollock, K. and et. al., 2020. What do family care-givers want from domiciliary care for relatives
living with dementia? A qualitative study. Ageing & Society, pp.1-14.
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